Individual
NICHOLAS COLE HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
441 S WHITLEY DR, FRUITLAND, ID 83619-2542
(208) 452-7197
(208) 452-4811
Mailing address
441 S WHITLEY DR, FRUITLAND, ID 83619-2542
(208) 452-7197
(208) 452-4811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-3815
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699166843
—
ID
Enumeration date
02/10/2015
Last updated
12/06/2017
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