Individual
JESSICA NICOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
220 S RIVER ST, PLAINS, PA 18705-1137
(620) 755-2946
Mailing address
PO BOX 1111, GOULDSBORO, PA 18424
(620) 755-2946
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI003595
PA
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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