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Individual

DR. ROCKY VANNUCCI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
401 N ROCK ST, SHERIDAN, AR 72150-2227
(870) 942-4646
Mailing address
401 N ROCK ST, SHERIDAN, AR 72150-2227
(870) 942-4646

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1042
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110468718
AR
01
350008095
RAILROAD MEDICARE
AR
01
4420017
UNITED HEALTHCARE
AR
01
5362237
AETNA
AR
01
59926
BLUE CROSS BLUE SHIELD
AR
01
CP43510
UNION PACIFIC RAILROAD
AR
Enumeration date
05/12/2006
Last updated
06/08/2012
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