Individual
MR. NICHOLAS EDWARD SHREVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
298 TRICORN RD, DANVILLE, WV 25053-7148
(304) 369-1385
Mailing address
325 4TH ST W, MADISON, WV 25130-1016
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001310
WV
Other
Enumeration date
11/05/2007
Last updated
03/03/2023
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