Individual
BETHANY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
208 NE SHADY OAKS DR, BURLESON, TX 76028-2508
(817) 447-0404
Mailing address
208 NE SHADY OAKS DR, BURLESON, TX 76028-2508
(817) 447-0404
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2066252
TX
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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