Individual
NICOLE SANFACON KLUCKHOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
43 THISTLE BROOK CT, GREENVILLE, SC 29615-4349
(864) 907-5324
(833) 615-4258
Mailing address
43 THISTLE BROOK CT, GREENVILLE, SC 29615-4349
(864) 907-5324
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3529
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1787
—
SC
Enumeration date
09/14/2006
Last updated
03/24/2025
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