Individual
CHADWICK NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1698 W HIBISCUS BLVD STE A, MELBOURNE, FL 32901-2639
(321) 786-6119
Mailing address
550 BROOKEDGE TER, SEBASTIAN, FL 32958-5912
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23318
FL
Other
Enumeration date
07/19/2014
Last updated
07/19/2014
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