Individual
NICOLE A PEASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
588 LONGMEADOW ST, LONGMEADOW, MA 01106-2292
(413) 565-1016
Mailing address
1 WINDWOOD DR, WINDSOR LOCKS, CT 06096-1610
(413) 896-2530
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2131
MA
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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