Individual
PHILLIP JAMES NIKLOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
331 MEADOWS DR, GRAYLING, MI 49738-2016
(989) 619-7524
Mailing address
714 W GILFORD RD, CARO, MI 48723-1013
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201001877
MI
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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