Individual
SHIRLEY DIANNE NICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
8450 BUTTS CANYON ROAD, POPE VALLEY, CA 94567
(707) 965-9242
(707) 965-9242
Mailing address
8450 BUTTS CANYON ROAD, PO BOX 146, POPE VALLEY, CA 94567
(707) 965-9242
(707) 965-9242
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
CA
Other
Enumeration date
05/01/2009
Last updated
05/01/2009
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