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General NPI Number Information
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NPI Number | 1427685569
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Entity Type | Organization
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Legal Business Name | PERCUOCO CHIROPRACTIC AND REHABILITATION, PLLC
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 3200 INGERSOLL AVE STE E
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City | DES MOINES
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State | IA
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Zip | 50312-3917
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Country | US
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Telephone | 515-620-3550
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Fax | 515-259-6383
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Provider Business Mailing Address
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Address Line | 8601 WESTOWN PKWY UNIT 5106
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1653
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Country | US
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Telephone | 563-370-0776
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. KEVIN THOMAS PERCUOCO
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Credential | DC
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Telephone | 515-620-3550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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