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Individual

MRS. NICOLE ANN BORMANN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
1 JEFFERSON BARRACKS DR, MAIL CODE: 117, SAINT LOUIS, MO 63125-4181
(314) 894-6629
(314) 845-5077
Mailing address
6955 SINGINGWOOD LN, SAINT LOUIS, MO 63129-5335
(314) 293-0387

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2003005733
MO

Other

Enumeration date
05/10/2006
Last updated
07/08/2007
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