Individual
TIMOTHY JAMES NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(619) 997-1568
Mailing address
1733 S XANTHUS AVE, TULSA, OK 74104-5323
(619) 997-1568
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
778
OK
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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