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NICHOLAS BACCIOCCO

>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1104235720

Individual Registrant:
 NICHOLAS  BACCIOCCO 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1850 BITTERROOT DR  TWIN FALLS, ID 83301-3513 US
Tel: 801-674-5752  Fax: --

Contact information for business:
1850 BITTERROOT DR  TWIN FALLS, ID 83301-3513 US
Tel: 801-674-5752  Fax: --

Registration Information:
NPI: 1104235720
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Occupational Therapy Assistant
IDOTA-1351

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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