Individual
NICCOLE J MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1225
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5834040
—
SD
Enumeration date
10/18/2005
Last updated
11/05/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up