Individual
NIKITA NICKLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
147 LAFAYETTE MANOR RD, UNIONTOWN, PA 15401-8900
(724) 430-4848
Mailing address
96 MAYFLOWER DR, UNIONTOWN, PA 15401-5284
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI003176
PA
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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