Individual
NICOLE MARIE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
29377 RANCHO CALIFORNIA RD STE 100, TEMECULA, CA 92591-5206
(951) 296-0400
Mailing address
16500 KIWI WAY, LAKE ELSINORE, CA 92530-1728
(760) 217-7718
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT9394
CA
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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