Individual
COURTNEY NICODEMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14286 BEACH BLVD STE 34, JACKSONVILLE, FL 32250-1570
(904) 345-7510
Mailing address
3901 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4312
(904) 345-7251
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTT35142
FL
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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