Individual
BRIAN J NICKERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
100 W GORE ST, SUITE 204, ORLANDO, FL 32806-1044
(407) 835-8818
(407) 835-8878
Mailing address
130 AVERY LAKE DR, WINTER SPRINGS, FL 32708-5191
(407) 971-1883
(407) 835-8878
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 96
FL
Other
Enumeration date
06/24/2006
Last updated
07/08/2007
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