Individual
MRS. MICHELLE MARIE NISSLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1380 ELM AVE, LANCASTER, PA 17603-4642
(717) 391-6430
Mailing address
1380 ELM AVE, LANCASTER, PA 17603-4642
(717) 391-6430
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI000938
PA
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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