Provider Demographics
NPI:1588606073
Name:ZUCCO, JOSEPH R (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:R
Last Name:ZUCCO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 CHENAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-5214
Mailing Address - Country:US
Mailing Address - Phone:501-975-4040
Mailing Address - Fax:501-975-4043
Practice Address - Street 1:13100 CHENAL PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-5214
Practice Address - Country:US
Practice Address - Phone:501-975-4040
Practice Address - Fax:501-975-4043
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00277504OtherRAILROAD MEDICARE
AR5Y374OtherBLUE CROSS BLUE SHIELD
P00277504OtherRAILROAD MEDICARE