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Organization
PANOPTIC PMR LLC
Active
Organization
PANOPTIC PMR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER TODD NICHOLS MD (MD/OWNER)
(251) 377-5228
Entity
Organization
Contact information
Practice address
8088 HAWKS RD, LEESVILLE, LA 71446-6649
(251) 377-5228
Mailing address
711 7TH ST, LAKE CHARLES, LA 70601-6274
(251) 377-5228
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/18/2020
Last updated
03/04/2021
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