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NPI Code Detail

MEDICARE: DR. YOLANDA ALICIA PETOCCHI DC

MEDICARE:  DR. YOLANDA ALICIA PETOCCHI  DC
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
1111N00000XChiropractor5045KY
2111N00000XChiropractorX011236NY
3111N00000XChiropractorDC009622PA

General Provider Information

NPI Number : 1275686560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YOLANDA ALICIA PETOCCHI DC
Provider Business Mailing Address
First Line : 845 EAGLE CREST DR
Second Line :
City : VERSAILLES
State : KY
Zip : 40383-1930
Country : US
Telephone Number : 585-703-9713
Fax Number :
Provider Business Practice Location Address
First Line : 100 EASTSIDE DR
Second Line :
City : GEORGETOWN
State : KY
Zip : 40324-9797
Country : US
Telephone Number : 502-868-0097
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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Directions to “ DR. YOLANDA ALICIA PETOCCHI DC” Practice Location

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