Individual
LYNETTE KAY NICOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
345 N 2ND ST W, SNOWFLAKE, AZ 85937-5380
(928) 243-8003
Mailing address
PO BOX 891, TAYLOR, AZ 85939-0891
(928) 243-8003
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT-11800
AZ
Other
Enumeration date
02/16/2022
Last updated
02/16/2022
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