MEDICARE: DR. BRYAN T RUOCCO 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
1	111N00000X	Chiropractor	3020	MA

General Provider Information

NPI Number	:	1750362273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN T RUOCCO DC

Provider Business Mailing Address
First Line	:	111 PLEASANT ST
Second Line	:
City	:	MARBLEHEAD
State	:	MA
Zip	:	01945-2339
Country	:	US
Telephone Number	:	781-631-3333
Fax Number	:	781-631-3339

Provider Business Practice Location Address
First Line	:	111 PLEASANT ST
Second Line	:
City	:	MARBLEHEAD
State	:	MA
Zip	:	01945-2339
Country	:	US
Telephone Number	:	781-631-3333
Fax Number	:	781-631-3339

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	03/14/2025

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