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General NPI Number Information
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NPI Number | 1679148993
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Entity Type | Organization
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Legal Business Name | NICHOLS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 1809 N BINGHAM DR
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City | NAMPA
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State | ID
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Zip | 83651-1764
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Country | US
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Telephone | 208-466-6959
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Fax | 208-465-9901
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Provider Business Mailing Address
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Address Line | 1809 N BINGHAM DR
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City | NAMPA
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State | ID
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Zip | 83651-1764
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Country | US
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Telephone | 208-466-6959
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Fax | 208-465-9901
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | CHRISTOPHER NICHOLS
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Credential | DPT
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Telephone | 208-466-6959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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