Individual
NICHOLAS ANDREW LOCOCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4242 POPPS FERRY RD STE A, DIBERVILLE, MS 39540-2391
(228) 392-5543
Mailing address
4242 POPPS FERRY RD STE A, DIBERVILLE, MS 39540-2391
(228) 392-5543
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1133
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00874294
—
MS
01
—
26-3078685
TAX ID
—
Enumeration date
08/05/2008
Last updated
05/02/2013
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