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Individual

BRIAN MCNICHOLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 CALLOWHILL ST STE 101, PHILADELPHIA, PA 19123-3658
(215) 825-8220
(215) 825-8254
Mailing address
260 S BROAD ST, PHILADELPHIA, PA 19102-5021

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN605632
PA

Other

Enumeration date
10/16/2012
Last updated
10/16/2012
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