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Individual

MRS. TONI MARIE NICKELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
19830 SUMPTER STAGE HWY, BAKER CITY, OR 97814-7759
(541) 523-2935
Mailing address
19830 SUMPTER STAGE HWY, BAKER CITY, OR 97814-7759
(541) 523-2935

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
450825
OR

Other

Enumeration date
06/10/2008
Last updated
06/10/2008
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