Individual
TERRENCE LICCIARDI III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
23 STILES RD, SALEM, NH 03079-2859
(603) 898-3129
Mailing address
37 14TH AVE, HAVERHILL, MA 01830-3232
(978) 521-0998
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
06481
MA
2471C3402X
Radiography Radiologic Technologist
Primary
06481
MA
Other
Enumeration date
06/27/2007
Last updated
09/29/2008
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