Individual
CORY NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1339 S PATRICK DR, SATELLITE BEACH, FL 32937-4325
(321) 961-8405
Mailing address
1339 S PATRICK DR, SATELLITE BEACH, FL 32937-4325
(321) 961-8405
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA15172
FL
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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