Individual
ERICA NICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 722-2062
Mailing address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 722-2062
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4691
TN
Other
Enumeration date
03/08/2013
Last updated
03/08/2013
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