Provider Demographics
NPI:1174199293
Name:ROCCO DIANA DC, P.C.
Entity type:Organization
Organization Name:ROCCO DIANA DC, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCCO
Authorized Official - Middle Name:G
Authorized Official - Last Name:DIANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-351-5911
Mailing Address - Street 1:1186 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-9346
Mailing Address - Country:US
Mailing Address - Phone:570-842-5131
Mailing Address - Fax:570-842-5126
Practice Address - Street 1:1186 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-9346
Practice Address - Country:US
Practice Address - Phone:570-842-5131
Practice Address - Fax:570-842-5126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-30
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty