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Individual

NICOLE SUMMERLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
225 WHITE ST, JACKSONVILLE, NC 28546-6351
(910) 353-7222
Mailing address
387 STOKES GOODING ROAD, KENANSVILLE, NC 28349
(910) 296-0834

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2919
NC

Other

Enumeration date
07/03/2008
Last updated
07/03/2008
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