Individual
ANGELA LYNN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5273 CADWALLADER SONK RD, FOWLER, OH 44418-9735
(724) 718-8389
Mailing address
PO BOX 84, FOWLER, OH 44418-0084
(724) 718-8389
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.012112
OH
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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