Individual
NICK COOLIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1140 E MICHIGAN AVE STE 200, LANSING, MI 48912-1806
(517) 364-9400
Mailing address
6039 WILLOMERE CIR, WINSTON SALEM, NC 27107-3731
(517) 231-0439
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
0010-09447
NC
363AM0700X
Medical Physician Assistant
Primary
5315244432
MI
Other
Enumeration date
06/03/2015
Last updated
09/21/2023
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