Individual
DR. MICHAEL A NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
100 FOUNTAIN AVE, SUITE 220, PADUCAH, KY 42001-2771
(270) 408-4192
(270) 443-1784
Mailing address
PO BOX 7223, PADUCAH, KY 42002-7223
(270) 408-4192
(270) 443-1784
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
850
KY
Other
Enumeration date
07/19/2006
Last updated
06/05/2008
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