Individual
NICOLE SULICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
47773 HWY 58, OAKRIDGE, OR 97463
(541) 913-2557
Mailing address
76506 PORTAL DR, OAKRIDGE, OR 97463-9755
(541) 913-2557
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14349
OR
Other
Enumeration date
11/07/2008
Last updated
11/07/2008
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