Provider Demographics
NPI:1346454931
Name:PICCIUTO, JEFFREY M (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:PICCIUTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 W ALISAL ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-1161
Mailing Address - Country:US
Mailing Address - Phone:831-424-5454
Mailing Address - Fax:831-424-6200
Practice Address - Street 1:975 W ALISAL ST
Practice Address - Street 2:SUITE E
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-1161
Practice Address - Country:US
Practice Address - Phone:831-424-5454
Practice Address - Fax:831-424-6200
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor