Individual
DR. NICOLE MICHELLE HEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
7196 CRESTWOOD BLVD STE 100, FREDERICK, MD 21703-1845
(301) 698-0001
Mailing address
7196 CRESTWOOD BLVD, FREDERICK, MD 21703-1844
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S03925
MD
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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