Individual
JACQUELINE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1130 COLLINS RD, JEFFERSON, WI 53549-2939
(262) 470-6950
(262) 470-6950
Mailing address
412 E FOREST ST, OCONOMOWOC, WI 53066-3708
(262) 470-6950
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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