Individual
NICHOLAS SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
6652 MARMADUKE AVE, APT 1F, SAINT LOUIS, MO 63139-2508
(419) 631-0979
Mailing address
6652 MARMADUKE AVE, APT 1F, SAINT LOUIS, MO 63139-2508
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2016032054
MO
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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