Individual
MRS. SANDRA NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
711 N 5TH ST, JENKS, OK 74037-3343
(918) 299-8508
Mailing address
1733 S XANTHUS AVE, TULSA, OK 74104-5323
(661) 350-4473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5218
OK
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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