Individual
NICOLE LORD WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1800 LOMBARD ST, PHILADELPHIA, PA 19146-1414
(215) 893-6324
Mailing address
404 GALWAY CT, MIDDLETOWN, DE 19709-8796
(484) 557-9550
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE011620
PA
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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