Individual
DEREK BACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6211
Mailing address
14519 OTIS DR, NORTH HUNTINGDON, PA 15642-1011
(412) 592-4494
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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