Individual
MRS. CHERYL SHARPE NICKISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
590 WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7005
(801) 587-7007
Mailing address
590 WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7005
(801) 587-7007
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
10151
NC
2251X0800X
Orthopedic Physical Therapist
Primary
6705120-2401
UT
Other
Enumeration date
11/30/2005
Last updated
08/15/2007
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