Individual
MR. GREGORY PETER NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
552 OLD SMIZER MILL RD, FENTON, MO 63026
(636) 349-8060
(636) 349-9171
Mailing address
4273 KEATON CROSSING BLVD, O FALLON, MO 63368-8220
(636) 206-4225
(636) 422-1051
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2000173375
MO
Other
Enumeration date
08/29/2006
Last updated
07/30/2019
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