# PANOPTIC PMR LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508482241
- **Authorized official:** CHRISTOPHER TODD NICHOLS MD (MD/OWNER)
- **Authorized official phone:** (251) 377-5228

## Contact information

- **Practice address:** 8088 HAWKS RD, LEESVILLE, LA 71446-6649
- **Practice address phone:** (251) 377-5228
- **Mailing address:** 711 7TH ST, LAKE CHARLES, LA 70601-6274
- **Mailing address phone:** (251) 377-5228

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2020
- **Last updated:** 03/04/2021