Individual
MICHAEL DICICCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BOCP, BEBOCO, CPED
Contact information
Practice address
725 HAMILTON ST, STE D, ROANOKE RAPIDS, NC 27870-2746
(252) 535-0077
(252) 535-0078
Mailing address
725 HAMILTON ST, STE D, ROANOKE RAPIDS, NC 27870-2746
(252) 535-0077
(252) 535-0078
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
05/01/2014
Last updated
05/14/2014
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