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Individual

KELLY NICHOLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 CRAVEN RD, SAN MARCOS, CA 92078-4201
(760) 510-5572
Mailing address
400 CRAVEN RD, SAN MARCOS, CA 92078-4201

Taxonomy

Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
24314
CA

Other

Enumeration date
09/13/2018
Last updated
09/13/2018
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