Individual
MRS. NICOLE PENWELL MINCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
6707 LAKE VIEW DR, GLOUCESTER, VA 23061-2839
(804) 824-8471
Mailing address
6707 LAKE VIEW DR, GLOUCESTER, VA 23061-2839
(804) 824-8471
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602972
VA
Other
Enumeration date
11/09/2010
Last updated
11/09/2010
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