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Individual

MRS. JULIE SENECAL NICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
12600 N PORT WASHINGTON RD, MEQUON, WI 53092-3469
(262) 387-8818
Mailing address
604 PARK CREST DR, THIENSVILLE, WI 53092-1423
(704) 661-3829

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11889-24
WI

Other

Enumeration date
01/27/2014
Last updated
01/27/2014
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