Individual
MRS. CAROL ANN NICKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
315 MAIN ST, VALLEY KIDS THERAPY, MT. VERNON, WA 98273-2314
(360) 336-3432
Mailing address
5484 CANVASBACK ROAD, BLAINE, WA 98230
(360) 371-3148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009559
WA
225100000X
Physical Therapist
PT1714
CA
Other
Enumeration date
04/29/2011
Last updated
04/29/2011
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