Individual
CASIE RENEE NICKOLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S,PTA, ATC, AT/L
Contact information
Practice address
965 GOETHALS DR, RICHLAND, WA 99352-3527
(509) 460-5588
(509) 783-5438
Mailing address
6703 W RIO GRANDE AVE, KENNEWICK, WA 99336-2623
(509) 460-5588
(509) 783-5438
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
2255A2300X
Athletic Trainer
A160245265
WA
Other
Enumeration date
05/18/2017
Last updated
06/08/2021
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