Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DAVID IANNICCA, ATC
Active Sole ProprietorDAVID IANNICCA, ATC is a Sports Medicine (PM&R) healthcare provider located in SURPRISE, Arizona. NPI 1245455666 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · SURPRISE, AZ
Registration Details
- NPI Number
- 1245455666
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 13, 2007 (19.330607156432 yrs)
- Last Updated
- Jul 8, 2007
- License
-
0126000756 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
15946 N BULLARD AVESURPRISE, AZ, 853748844Browse AZ providers · Browse ZIP 85374
- Phone
- 8162772954
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
Other Sports Medicine (PM&R) Providers in SURPRISE, AZ
| Name | Credential | NPI |
|---|---|---|
| GAVIN GROSH | — | 1306333182 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.