Individual
CASEY L NICOLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
350 MAIN ST NW, UNIT B, BOURBONNAIS, IL 60914-2383
(815) 936-1855
Mailing address
540 OAK RUN DR, APT 8, BOURBONNAIS, IL 60914-1776
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL1767
FL
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
04/03/2006
Last updated
07/08/2007
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