Individual
MR. NICHOLAS EVERETT WILKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
901 CALLE AMANECER, SAN CLEMENTE, CA 92673-6278
(949) 366-6785
Mailing address
PO BOX 73993, SAN CLEMENTE, CA 92673-0134
(949) 366-6785
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 10466
CA
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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