Provider Demographics
NPI:1437605243
Name:DELLA CROCE, ANTHONY (LAC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:DELLA CROCE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 S ROSEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-4462
Mailing Address - Country:US
Mailing Address - Phone:520-248-3897
Mailing Address - Fax:
Practice Address - Street 1:518 S ROSEMONT AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-4462
Practice Address - Country:US
Practice Address - Phone:520-248-3897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0970171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist