Individual
MR. JON NICKOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5600 SAMSTONE CT, BLUE ASH, OH 45242-5700
(513) 207-5408
Mailing address
5600 SAMSTONE CT, BLUE ASH, OH 45242-5700
(513) 207-5408
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
0118281
OH
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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