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Individual

NICOLE TIRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED, LAT, ATC

Contact information

Practice address
10 S RAZORBACK RD, FAYETTEVILLE, AR 72701
(479) 249-7823
Mailing address
10 S RAZORBACK RD, FAYETTEVILLE, AR 72701
(479) 249-7823

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
AT778
AR

Other

Enumeration date
11/30/2023
Last updated
11/30/2023
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