Individual
KYLE WAYNE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5 MYERS DR STE 101, MULLICA HILL, NJ 08062-9517
(856) 845-7968
Mailing address
3046 KNIGHTS RD, BENSALEM, PA 19020-2815
(215) 639-4500
(215) 604-0355
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00711200
NJ
152W00000X
Optometrist
OEG003675
PA
Other
Enumeration date
06/01/2020
Last updated
04/23/2025
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