Provider Demographics
NPI:1639453178
Name:TOCCO, LIA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LIA
Middle Name:MARIE
Last Name:TOCCO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4820 FOX CRK E
Mailing Address - Street 2:#135
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4946
Mailing Address - Country:US
Mailing Address - Phone:248-802-7743
Mailing Address - Fax:
Practice Address - Street 1:1424 N ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-1188
Practice Address - Country:US
Practice Address - Phone:248-650-6100
Practice Address - Fax:248-650-3751
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor