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Individual
MILES NICHOLAS
Active
Individual
MILES NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
24469
MA
225100000X
Physical Therapist
PT029363
PA
225100000X
Physical Therapist
Primary
PTL.0018069
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24469
MA ALLIED HEALTH
MA
Enumeration date
08/12/2019
Last updated
01/17/2024
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