Individual
AMANDA DONN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
361 WINDBURN LN, GRAYSON, KY 41143-8372
(606) 316-1171
Mailing address
951 STATE ROUTE 784, SOUTH SHORE, KY 41175-9791
(606) 694-0396
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03551
KY
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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