Individual
NICHOLAS TYLER WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
200 JOHN ROBERTS RD, SOUTH PORTLAND, ME 04106-3366
(207) 831-1956
Mailing address
3 BUDS TRL, CUMBERLAND, ME 04021-3162
(207) 831-1956
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5750
ME
Other
Enumeration date
09/04/2020
Last updated
09/11/2023
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