Individual
MELISSA NICELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
103697 S PROGRESS RD, MEEKER, OK 74855-5507
(405) 202-8453
Mailing address
103697 S PROGRESS RD, MEEKER, OK 74855-5507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3555
OK
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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