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Individual

JOSEPH JOHN NICHOLS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
28535 DUPONT BLVD, UNIT 1, MILLSBORO, DE 19966-4799
(302) 297-0700
(302) 297-0701
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
18065
MD
225100000X
Physical Therapist
Primary
J10000921
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000220726
DE
Enumeration date
11/03/2006
Last updated
03/28/2016
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