Individual
MRS. KIMBERLY ANN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
11702 MERCY BLVD # B-2C, SAVANNAH, GA 31419-1750
(912) 819-2446
Mailing address
132 BLAIR WAY, GUYTON, GA 31312-5316
(912) 531-6887
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002573
GA
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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