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Individual

GARRETT WAYNE NICOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, ATC

Contact information

Practice address
7201 E 147TH ST STE 120, GRANDVIEW, MO 64030
(816) 425-3580
(816) 425-3641
Mailing address
200 W DOUGLAS AVE STE 1040, WICHITA, KS 67202-3017
(316) 263-0003
(316) 263-1241

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11-05883
KS
225100000X
Physical Therapist
Primary
2018025002
MO

Other

Enumeration date
07/12/2018
Last updated
12/02/2019
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