Individual
NICOLE DICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5123 JUAN TABO BLVD NE, ALBUQUERQUE, NM 87111-2672
(505) 292-3333
Mailing address
5808 CANYON VISTA DR NE, ALBUQUERQUE, NM 87111-6616
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1329
NM
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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