Individual
NICOLE DIANNE BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
410 NEW BRIDGE ST, SUITE 10A, JACKSONVILLE, NC 28540-4739
(910) 347-2212
(910) 347-6003
Mailing address
410 NEW BRIDGE ST, SUITE 10A, JACKSONVILLE, NC 28540-4739
(910) 347-2212
(910) 347-6003
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2865
NC
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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