Individual
MR. NICHOLAS REYNARD HUCKABY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2575 AIRLINE DR, BOSSIER CITY, LA 71111-5812
(318) 286-5445
Mailing address
2376 FERNBROOK DR, SHREVEPORT, LA 71118-5215
(318) 686-0601
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06844
LA
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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