Individual
MS. TRACY ANN NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1236 S LAPEER RD, LAKE ORION, MI 48360-1433
(248) 712-4266
Mailing address
1236 S LAPEER RD, LAKE ORION, MI 48360-1433
(248) 712-4266
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
06/24/2022
Last updated
06/27/2022
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