Individual
MRS. BONNIE SUE NICHOLLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100 W GORE ST, SUITE 301, ORLANDO, FL 32806-1044
(407) 481-8861
(407) 481-8862
Mailing address
10406 KRISTEN PARK DR, ORLANDO, FL 32832-5824
(407) 273-0768
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20215
FL
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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