Provider Demographics
NPI:1659974434
Name:PARRECO, THEODORE J
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:J
Last Name:PARRECO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7813
Mailing Address - Country:US
Mailing Address - Phone:614-581-2976
Mailing Address - Fax:
Practice Address - Street 1:3240 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7813
Practice Address - Country:US
Practice Address - Phone:614-581-2976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker