Individual
NICOLE ZICCARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5219 88TH AVE, KENOSHA, WI 53144-7468
(262) 653-0853
(262) 653-0853
Mailing address
4111 HARDING RD, KENOSHA, WI 53142-7040
(262) 652-9813
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
445-019
WI
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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