Individual
MR. DOMINICK PETACCIO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1920 FRONTAGE RD APT 1603, CHERRY HILL, NJ 08034-2224
(856) 562-3393
Mailing address
1920 FRONTAGE RD APT 1603, CHERRY HILL, NJ 08034-2224
(856) 562-3393
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00750100
NJ
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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