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General NPI Number Information
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NPI Number | 1720103633
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Entity Type | Individual
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Provider Name | NICK GREGORY ABRAM L.M.T.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 311 DEL PRADO BLVD SUITE 7
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City | CAPE CORAL
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State | FL
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Zip | 33909
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Country | US
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Telephone | 239-573-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 447 NE 8TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33909-1969
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Country | US
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Telephone | 239-229-7318
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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 | 175L00000X
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Taxonomy Name | Homeopath
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License Number | 40658
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License Number State | FL
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