Individual
DEVON NICELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1920 BARNEY RD, ANDERSON, CA 96007-4337
(193) 775-0024
Mailing address
877 WIND FOREST DR, SPRINGBORO, OH 45066-9016
(193) 775-0024
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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