Individual
NICOLE MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5565 GYDDIE DR, WINSTON SALEM, NC 27105-9606
(336) 817-4311
Mailing address
5565 GYDDIE DR, WINSTON SALEM, NC 27105-9606
(336) 817-4311
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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