Individual
TAMARA GERRY NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
4440 N 36TH ST STE 240, PHOENIX, AZ 85018-3592
(602) 956-4040
(602) 956-4011
Mailing address
4440 N 36TH ST STE 240, PHOENIX, AZ 85018-3592
(602) 956-4040
(602) 956-4011
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
9819
AZ
2251X0800X
Orthopedic Physical Therapist
Primary
9819
AZ
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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