Individual
KATIE J. MICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 FAIRFIELD DR, SENECA, PA 16346-2130
(814) 678-4655
Mailing address
437 CAREY LN, CRANBERRY, PA 16319-3007
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE1002093
PA
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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