Individual
NICHOLE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
6620 COYLE AVE STE 301, CARMICHAEL, CA 95608-6337
(916) 671-3417
(916) 241-9344
Mailing address
6620 PENNEY WAY, CARMICHAEL, CA 95608-0937
(530) 410-8093
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
C70683
CA
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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