Individual
AMANDA MARIE NICOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
400 HEATH ST, CHESTNUT HILL, MA 02467-2332
(617) 731-7057
(617) 731-7035
Mailing address
400 HEATH ST, CHESTNUT HILL, MA 02467-2332
(617) 731-7057
(617) 731-7035
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1614
MA
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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