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General NPI Number Information
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NPI Number | 1811882657
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Entity Type | Individual
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Provider Name | NICHOLAS ROCCO DPT
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Gender | Male
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 939 HIGHWAY K
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City | O FALLON
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State | MO
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Zip | 63366-2910
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Country | US
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Telephone | 636-240-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 185 SANCTUARY DR
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City | DARDENNE PRAIRIE
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State | MO
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Zip | 63368-8274
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2025020314
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License Number State | MO
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