Provider Demographics
NPI:1548597990
Name:SACCO, RONALD FRANCIS (LMT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:FRANCIS
Last Name:SACCO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W CAMELBACK RD
Mailing Address - Street 2:1-W
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-3513
Mailing Address - Country:US
Mailing Address - Phone:602-277-6859
Mailing Address - Fax:
Practice Address - Street 1:1600 W CAMELBACK RD
Practice Address - Street 2:1-W
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3513
Practice Address - Country:US
Practice Address - Phone:602-277-6859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-00251P225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist