Individual provider · Type 1 NPI
Jodi Iacco
Surgical Physician Assistant · Detroit, MI
NPI number
1801162532
Active
Practice location
22201 Moross Rd, Professional Building 1 Suite 132
Detroit, MI 48236-2169
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 5601006048 (MI) |
Surgical Physician Assistant: Definition to come...
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About NPI 1801162532
Jodi Iacco's National Provider Identifier is 1801162532, issued on Mar 27, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Detroit, MI. The record was last updated on Mar 27, 2012.