DR. Jim Paul Licandro, DPM
NPI #1609873538 in Long Grove, Iowa
Provider Information
- NPI Number
- 1609873538
- Entity Type
- Individual
- Name
- DR. Jim Paul Licandro, DPM
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Podiatrist
- Credential
- DPM
- Enumeration Date
- Jul 7, 2005
- Last Updated
- Jul 22, 2018
Practice Location
- Address
- 405 WOODLAWN RD
- City
- Long Grove
- State
- Iowa
- ZIP Code
- 52756
- Phone
- (832) 425-7457
Specialties & Taxonomy Codes
| Specialty |
|---|
| Podiatrist |
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