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Individual
MRS. NICHOLE MARIE EICKHOLT
Active
Individual
MRS. NICHOLE MARIE EICKHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012916
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N45090
MEDICARE GRP PTAN
MI
Enumeration date
03/05/2009
Last updated
07/03/2024
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