Individual
ISIDORA NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
115 BARTRAM OAKS WALK, STE. 104, SAINT JOHNS, FL 32259-3243
(904) 240-0471
(904) 240-0471
Mailing address
9765 SOUTHBROOK DR, APT. 2203, JACKSONVILLE, FL 32256-0459
(863) 712-0988
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 2854
FL
Other
Enumeration date
02/18/2013
Last updated
02/18/2013
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