Individual
ADAM NICODEMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 N 450 W, COLUMBIA CITY, IN 46725-9141
(260) 239-5177
Mailing address
2400 N 450 W, COLUMBIA CITY, IN 46725-9141
(260) 239-5177
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
36002136A
IN
Other
Enumeration date
07/26/2014
Last updated
07/26/2014
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