Individual
RANDALL NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2900 GOLF RD, PEWAUKEE, WI 53072-5449
(262) 928-7356
Mailing address
3756 NAGAWICKA SHORES DR, HARTLAND, WI 53029-8817
(262) 470-3279
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
WI
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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