Provider Demographics
NPI:1427120401
Name:GIACOMA, NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:GIACOMA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N WILMOT RD
Mailing Address - Street 2:SUITE 229
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5100
Mailing Address - Country:US
Mailing Address - Phone:520-603-6248
Mailing Address - Fax:520-721-0325
Practice Address - Street 1:1101 N WILMOT RD
Practice Address - Street 2:SUITE 229
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-5100
Practice Address - Country:US
Practice Address - Phone:520-603-6248
Practice Address - Fax:520-721-0325
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor