Individual
DR. STACY LOUISE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
10015 OLD COLUMBIA RD, SUITE B215, COLUMBIA, MD 21046-1703
(410) 312-5454
Mailing address
9500 PAINTED TREE DR, RANDALLSTOWN, MD 21133-2845
(410) 312-5454
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
01749
MD
Other
Enumeration date
01/03/2007
Last updated
10/07/2014
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