Individual
BREANNA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 SHERIDAN SQ STE 100, KINGSPORT, TN 37660-7392
(423) 230-0194
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7568
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2306604823
VA
225200000X
Physical Therapy Assistant
Primary
7919
TN
Other
Enumeration date
07/08/2021
Last updated
07/23/2021
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