Individual
NICHOLE DEARBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3801 OLD BRUCEVILLE RD, VINCENNES, IN 47591-3889
(812) 886-4677
Mailing address
305 E 23RD ST N, NEWTON, IA 50208-2609
(641) 521-4940
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00774
IA
Other
Enumeration date
05/31/2007
Last updated
07/13/2012
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