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Individual

EMILY J NICHOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3747 SW RAINTREE DR, LEES SUMMIT, MO 64082-4606
(816) 537-5650
(816) 537-5649
Mailing address
17134 BEL RAY PL, BELTON, MO 64012-5331
(816) 226-4011
(816) 524-6115

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-03764
KS
225100000X
Physical Therapist
Primary
2008025329
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41478026
BCBS KC
01
MA4370047
MEDICARE PTAN
MO
Enumeration date
08/07/2008
Last updated
01/28/2014
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