Individual
SCOTT NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, ATC, CSCS
Contact information
Practice address
1102 SIKES AVE, SIKESTON, MO 63801-5021
(573) 471-5755
(573) 471-5884
Mailing address
1102 SIKES AVE, SIKESTON, MO 63801-5021
(573) 471-5755
(573) 471-5884
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
118530
MO
2255A2300X
Athletic Trainer
118415
MO
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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