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General NPI Number Information
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NPI Number | 1699330993
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Entity Type | Individual
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Provider Name | NICHOLAS MISSEL DPT
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Gender | Male
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 1000 HIGHLAND COLONY PKWY STE 2002
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City | RIDGELAND
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State | MS
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Zip | 39157-2075
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Country | US
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Telephone | 769-300-1101
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Fax | 769-300-1102
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Provider Business Mailing Address
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Address Line | 800 CRESCENT CENTRE DR STE 300
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City | FRANKLIN
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State | TN
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Zip | 37067-7285
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Country | US
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Telephone | 615-416-0199
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6682
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License Number State | MS
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