Individual
MRS. CAROL W. NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
RIVERSTREET MANOR, 440 NORTH MAIN STREET, WILKES BARRE, PA 18702
(570) 825-5611
Mailing address
53 E VAUGHN ST, KINGSTON, PA 18704-4817
(570) 288-5344
(570) 283-2167
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003123L
PA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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