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Individual

MRS. DONNA JEAN NUCKOLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1800 N WABASH RD, MARION, IN 46952-1300
(765) 651-3229
Mailing address
3430 W. 600 S., PORTLAND, IN 47371
(260) 726-5750

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002184A
IN

Other

Enumeration date
05/18/2008
Last updated
05/18/2008
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