Individual
JENNIFER S NICEWANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
250 12TH AVE, SUITE 160, CORALVILLE, IA 52241-2911
(319) 354-4800
(319) 354-4819
Mailing address
250 12TH AVE, SUITE 160, CORALVILLE, IA 52241-2911
(319) 354-4800
(319) 354-4819
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
072167
IA
2251X0800X
Orthopedic Physical Therapist
PT110022
MO
Other
Enumeration date
06/25/2006
Last updated
06/18/2014
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