Organization
TED M. NICKLAUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONSTANCE SUE KLAGGE (MEDICAL RECORDS ADMIN)
(806) 463-5111
Entity
Organization
Contact information
Practice address
101 WALLACE BLVD, AMARILLO, TX 79106
(806) 355-7453
Mailing address
PO BOX 7066, AMARILLO, TX 79114-7066
(806) 463-5111
(806) 463-5223
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
D2283
TX
Other
Enumeration date
10/22/2007
Last updated
11/03/2007
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