Individual
JAMIE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3810 ALDER LN, EAGAN, MN 55122-3831
(651) 379-2437
Mailing address
10653 WAYZATA BLVD, MINNETONKA, MN 55305-1528
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11292
MN
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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