Organization
MICHAEL A. NICHOLAS PHD PLLC
Active
Organization
MICHAEL A. NICHOLAS PHD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAYCHAL D WALKER (OFFICE MANAGER)
(270) 408-4192
Entity
Organization
Contact information
Practice address
100 FOUNTAIN AVE, SUITE 220, PADUCAH, KY 42001-2771
(270) 408-4192
Mailing address
PO BOX 7723, PADUCAH, KY 42002-7723
(270) 408-4192
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
850
KY
Other
Enumeration date
02/20/2008
Last updated
06/05/2008
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