Individual
SHAWN EDWARD NICHOLS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RMT
Contact information
Practice address
433 BROAD ST, COLUMBIA, MS 39429-3038
(601) 444-0030
(601) 444-0033
Mailing address
404 S 22ND AVE, HATTIESBURG, MS 39401-7315
(601) 606-6064
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT645
MS
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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