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General NPI Number Information
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NPI Number | 1265687222
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Entity Type | Individual
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Provider Name | NICK GERARD MICHELS H.I.S.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 459 N. CLAUDE A. LORD BLVD
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City | POTTSVILLE
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State | PA
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Zip | 17901
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Country | US
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Telephone | 570-622-9151
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Fax | 570-544-0395
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Provider Business Mailing Address
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Address Line | 53 WEST WEST AVE
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City | POTTSVILLE
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State | PA
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Zip | 17901
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Country | US
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Telephone | 570-622-9151
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Fax | 570-544-0395
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | F02624
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License Number State | PA
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