Individual
MR. BRYAN STUART NICOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1808 SW 9TH AVE STE 101, BATTLE GROUND, WA 98604-3284
(360) 723-0797
Mailing address
1226 VISTA OAKS DR, FOREST GROVE, OR 97116-3091
(503) 536-3841
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160585276
WA
2255A2300X
Athletic Trainer
AT-10174301
OR
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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