Individual
MR. NICHOLAS PERNELL VINES SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2201 SAGEWOOD DR, MONTGOMERY, AL 36117-2428
(334) 676-2414
Mailing address
2201 SAGEWOOD DR, MONTGOMERY, AL 36117-2428
(334) 676-2414
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5521
AL
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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