MEDICARE: DR. DAVID SAVERIO FICCO DC,NMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	2796	GA

General Provider Information

NPI Number	:	1114001245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SAVERIO FICCO DC,NMD

Provider Business Mailing Address
First Line	:	1860 ATKINSON RD
Second Line	:	SUITE 107-107
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30043-5065
Country	:	US
Telephone Number	:	770-497-0073
Fax Number	:	770-497-1773

Provider Business Practice Location Address
First Line	:	1885 LAWRENCEVILLE SUWANEE RD
Second Line	:	SUITE 130
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30043-1408
Country	:	US
Telephone Number	:	770-497-0073
Fax Number	:	770-497-1773

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	03/22/2017

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