Individual
DR. JARED CICERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
48 TUNNEL RD STE 203, POTTSVILLE, PA 17901
(570) 624-4777
Mailing address
48 TUNNEL RD, POTTSVILLE, PA 17901-3875
(570) 624-4777
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
481
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
481
KENTUCKY STATE LICENSE
KY
Enumeration date
07/10/2017
Last updated
04/06/2022
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