Individual
MS. LEANNE MARIE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, AT, ATC, PES
Contact information
Practice address
4128 E GRAND RIVER AVE, HOWELL, MI 48843-6538
(517) 540-1060
(517) 540-1063
Mailing address
144 MANCHESTER LN APT 3211, WATERFORD, MI 48327-2357
(810) 874-9122
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000838
MI
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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