Individual
GEORGE ROBERT NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 467-7600
Mailing address
40630 TAMARACK DR APT 101, CANTON, MI 48188-2834
(734) 725-1786
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802089266
MI
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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