Individual
MISS NIKOLA LEONORA PHILLIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3835 GREEN POND RD, BETHLEHEM, PA 18020-7568
(610) 332-8692
Mailing address
2140 JOHNSTON DR APT 5, BETHLEHEM, PA 18020-3386
(484) 661-3626
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004873
PA
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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