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Individual

ELIZABETH NICHOLS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
3200 S AIRPORT RD W, 146, TRAVERSE CITY, MI 49684-8117
(231) 941-5440
(231) 941-0893
Mailing address
336 W FRONT ST, 146, TRAVERSE CITY, MI 49684-2204
(231) 941-7788

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
EN002584
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1808535
MI
Enumeration date
12/14/2005
Last updated
08/26/2016
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