Individual
JENNIFER R. NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1000 FAIRVIEW AVENUE, CLIFTON FORGE, VA 24422-1990
(540) 862-9555
Mailing address
PO BOX 103, IRON GATE, VA 24448-0103
(540) 862-1662
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602542
VA
Other
Enumeration date
03/30/2010
Last updated
03/30/2010
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