Organization
NICOLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE GABRIELLE WILSON (INTERN)
(707) 704-3165
Entity
Organization
Contact information
Practice address
50 IRVING ST NW, WASHINGTON, DC 20422-0001
(202) 745-8000
Mailing address
1400 IRVING ST NW APT 712, WASHINGTON, DC 20010-2882
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
—
—
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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