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1427283894
DEREK MARIO DECICCO
IRVINE, CA
NPI
1427283894
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA 33639)
Enumeration Date
2009-05-28
Last Update Date
2011-02-04
Business Address
-- DEREK MARIO DECICCO MPT
15775 LAGUNA CANYON RD STE 110
IRVINE, CA 92618-3192
Phone number: 714-858-4617
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Mailing Address
-- DEREK MARIO DECICCO MPT
1154 MISSION DR
COSTA MESA, CA 92626-4209
Phone number: 714-382-0673
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