Doctor Name: | JOHN JOSEPH CICCARELLO |
NPI Number: | 1477954485 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | |
Business Practice Address: | Building 2515 Sightseeing Road Physical Therapy, Consolidated Troop Medical Clinic Fort Benning, GA - 319056100 |
Business Phone Number: | 7065442449 |
Business Fax Number: | |
Mailing Address: | Building 2515 Sightseeing Road, Physical Therapy, Consolidated Troop Medical Clinic FORT BENNING |
State: | GA |
Postal Code: | 319056100 |
Phone Number: | 7065442449 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2014 |
NPI Last Update Date: | 09/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |