Individual
ANDREW NUCKOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 4TH ST, WOODLAND, WA 98674-8488
(360) 225-9443
Mailing address
310 4TH ST, WOODLAND, WA 98674-8488
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160235428
WA
Other
Enumeration date
12/03/2013
Last updated
12/03/2013
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