Individual
MRS. NICKI LOUISE NEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
813 S. BUSINESS HWY. 65, BRANSON, MO 65616
(417) 334-6660
(417) 334-6661
Mailing address
813 S. BUSINESS HWY. 65, BRANSON, MO 65616
(417) 334-6660
(417) 334-6661
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001006206
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199107
BLUE CROSS BLUE SHIELD
MO
05
—
PENDING
—
MO
Enumeration date
10/23/2006
Last updated
07/09/2007
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