Individual
LESLEY D NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9827 WALKER ST, CYPRESS, CA 90630-3826
(714) 220-9001
(714) 220-9006
Mailing address
9827 WALKER ST, CYPRESS, CA 90630-3826
(714) 220-9001
(714) 220-9006
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT38761
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT38761
PHYSICAL THERAPY
CA
Enumeration date
02/21/2012
Last updated
12/02/2013
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