Individual
MR. MICHAEL MICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
70 DAY ST APT 2, BOSTON, MA 02130-1191
(339) 222-3758
Mailing address
70 DAY ST APT 2, BOSTON, MA 02130-1191
(339) 222-3758
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
24108
MA
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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