Individual
KATIE NIKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2 GRACEDALE AVE, NAZARETH, PA 18064-8785
(610) 829-3606
Mailing address
6088 SNYDERS CHURCH RD, BATH, PA 18014-9035
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE011470
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TE011470
STATE BOARD OF PHYSICAL THERAPY
PA
Enumeration date
01/08/2018
Last updated
01/08/2018
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