Individual
TRACY LYNN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
117 NORTHRIDGE DR STE C, VAN BUREN, AR 72956-6983
(479) 431-7460
Mailing address
1515 TRENTON CIR, VAN BUREN, AR 72956-2838
(479) 431-7460
(479) 785-8564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2566
OK
225100000X
Physical Therapist
Primary
PT 1369
AR
Other
Enumeration date
08/21/2014
Last updated
03/26/2022
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