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NPI Code Detail

MEDICARE: MR. STEPHEN WAYNE NICHOLS DC

MEDICARE: MR. STEPHEN WAYNE NICHOLS DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor1807GA

General Provider Information

NPI Number : 1033275094
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN WAYNE NICHOLS DC
Provider Business Mailing Address
First Line : 166 ATHENS ST
Second Line :
City : HARTWELL
State : GA
Zip : 30643-1851
Country : US
Telephone Number : 706-376-7183
Fax Number : 706-376-7184
Provider Business Practice Location Address
First Line : 166 ATHENS ST
Second Line :
City : HARTWELL
State : GA
Zip : 30643-1851
Country : US
Telephone Number : 706-376-7183
Fax Number : 706-376-7184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 07/08/2007

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Directions to “ MR. STEPHEN WAYNE NICHOLS DC” Practice Location

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