Provider Demographics
NPI:1023353414
Name:TOCCO CHIROPRACTIC PC
Entity type:Organization
Organization Name:TOCCO CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TOCCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-435-8435
Mailing Address - Street 1:807 W 14 MILE RD
Mailing Address - Street 2:14 MILE
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1403
Mailing Address - Country:US
Mailing Address - Phone:248-435-8435
Mailing Address - Fax:248-435-8431
Practice Address - Street 1:807 W 14 MILE RD
Practice Address - Street 2:14 MILE
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1403
Practice Address - Country:US
Practice Address - Phone:248-435-8435
Practice Address - Fax:248-435-8431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty