Individual
TAMARA L NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
4465 S 900 E, SALT LAKE CITY, UT 84124-2469
(801) 294-6907
(801) 294-6917
Mailing address
PO BOX 307, BOUNTIFUL, UT 84011-0307
(801) 294-6907
(801) 294-6917
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
344643-2401
UT
Other
Enumeration date
03/14/2007
Last updated
07/20/2009
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