Individual
MR. JEREMY ANDREW NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
131 WELLNESS DR, SUMMERSVILLE, WV 26651-5402
(304) 872-6503
Mailing address
131 WELLNESS DR, SUMMERSVILLE, WV 26651-5402
(304) 872-1162
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
WV
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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