Individual
AMANDA J NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
217 N 27TH ST, CLARKSBURG, WV 26301-2310
(304) 623-7800
(304) 623-0706
Mailing address
217 N 27TH ST, CLARKSBURG, WV 26301-2310
(304) 623-7800
(304) 623-0706
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
587800-10
WV
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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