Individual
MISS SARA JEAN NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
213 HERITAGE LN, CIRCLE PINES, MN 55014-5007
(612) 790-3618
Mailing address
213 HERITAGE LN, CIRCLE PINES, MN 55014-5007
(612) 790-3618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
166A
MN
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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