Individual
MS. JESSIE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
170 W MAIN ST, PURCELLVILLE, VA 20132-5827
(703) 313-2286
Mailing address
608 THUMPER DR, RANSON, WV 25438-4892
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002080
WV
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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