Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Vicky Walesca De Micco

Individual provider Physical Therapist · NPI 1316213408

Vicky Walesca De Micco is a Physical Therapist in Columbia, South Carolina. Practices as a sole proprietor. Licensed in New Jersey and South Carolina.

Licensed in
NJ, SC
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

731 Polo Rd
Columbia, SC 29223-4462
Phone: (803) 238-5635
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 7989 (SC)
Physical Therapist Taxonomy 225100000X · Licence 40QA01343000 (NJ)

Record details

NPI number1316213408
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 22, 2012
Last updated in NPPESOctober 12, 2016

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