MEDICARE: DR. LIA MARIE TOCCO D.C.

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	111N00000X	Chiropractor	2301009839	MI

General Provider Information

NPI Number	:	1639453178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LIA MARIE TOCCO D.C.

Provider Business Mailing Address
First Line	:	4820 FOX CRK E
Second Line	:	#135
City	:	CLARKSTON
State	:	MI
Zip	:	48346-4946
Country	:	US
Telephone Number	:	248-802-7743
Fax Number	:

Provider Business Practice Location Address
First Line	:	1424 N ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-1188
Country	:	US
Telephone Number	:	248-650-6100
Fax Number	:	248-650-3751

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

Provider Enumeration Date	:	10/03/2011
Last Update Date	:	10/11/2011

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