Individual
CHARLES NICHOLS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 W COLUMBIA AVE, SPOKANE, WA 99205-6224
(509) 294-5579
Mailing address
119 W COLUMBIA AVE, SPOKANE, WA 99205-6224
(509) 294-5579
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60360553
WA
2251G0304X
Geriatric Physical Therapist
Primary
60380553
WA
Other
Enumeration date
04/27/2020
Last updated
05/04/2020
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