Individual
GREGORY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1125 E SOUTH BLVD, MONTGOMERY, AL 36116-2313
(334) 284-8490
Mailing address
608 CASTLE BROOK DR, PRATTVILLE, AL 36066-5637
(334) 361-2219
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTH2137
LICENSE #
AL
Enumeration date
08/29/2006
Last updated
07/08/2007
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