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General NPI Number Information
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NPI Number | 1477719847
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Entity Type | Individual
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Provider Name | NICHOLAS ANDREW LOCOCO D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 4242 POPPS FERRY RD STE A
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City | DIBERVILLE
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State | MS
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Zip | 39540-2391
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Country | US
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Telephone | 228-392-5543
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Fax |
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Provider Business Mailing Address
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Address Line | 4242 POPPS FERRY RD STE A
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City | DIBERVILLE
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State | MS
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Zip | 39540-2391
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Country | US
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Telephone | 228-392-5543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1133
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License Number State | MS
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