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Individual
MR. PATRICK WAYNE MCNICKLE
Active
Individual
MR. PATRICK WAYNE MCNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2025033895
MO
225100000X
Physical Therapist
Primary
PTL.0021474
CO
Other
Enumeration date
08/05/2025
Last updated
09/11/2026
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