Individual
NICOLLE M TENNANT-NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S 1000 W, TOOELE, UT 84074-4010
(435) 843-3520
Mailing address
136 E 1910 N, TOOELE, UT 84074-8065
(435) 248-9140
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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