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Individual

ROBERT J NICKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
4362 CASCADE RD SE, GRAND RAPIDS, MI 49546-3600
(616) 465-6800
Mailing address
4161 MIRAMAR AVE NE, GRAND RAPIDS, MI 49525-1525
(616) 706-8415

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502006371
MI

Other

Enumeration date
06/12/2023
Last updated
06/12/2023
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