Individual
NICOLE TENNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2610 THOMAS DR, EL CENTRO, CA 92243-7512
(484) 764-4529
Mailing address
2610 THOMAS DR, EL CENTRO, CA 92243-7512
(484) 764-4529
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10937
CA
225200000X
Physical Therapy Assistant
TE010264
PA
Other
Enumeration date
08/15/2014
Last updated
03/03/2021
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