Individual
ANTHONY FRANCIS MICUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
170 KETTLES LN, MEDFORD, NY 11763-1552
(631) 834-7808
Mailing address
170 KETTLES LN, MEDFORD, NY 11763-1552
(631) 834-7808
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X006790-1
NY
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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