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Individual

DR. MICHAEL KENNETH NICOLAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
207 1ST AVE S, NEW ROCKFORD, ND 58356-1807
(701) 947-2121
(701) 947-2012
Mailing address
207 1ST AVE S STE A, NEW ROCKFORD, ND 58356-1800
(701) 947-2121
(701) 947-2012

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
573
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1458577
ND
01
17556
BLUE CROSS PROVIDER#
ND
Enumeration date
04/27/2006
Last updated
03/22/2023
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