Individual
ELEXA NICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 BENNOCH RD, ORONO, ME 04473-3620
(207) 866-4914
Mailing address
98 POPLAR ST, OLD TOWN, ME 04468-5901
(207) 745-4955
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA4696
ME
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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