Individual
BRIAN NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
605 TRUNECEK CIRCLE, RALEIGH, NC 27603
(919) 368-6359
Mailing address
605 TRUNECEK CIRCLE, RALEIGH, NC 27603
(919) 368-6359
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1738
NC
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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