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NPI 1962955393

NPI 1962955393 : NICOLE STUDWELL : WHITINSVILLE, MA

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General NPI Number Information
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    NPI Number           |    1962955393
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLE STUDWELL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/02/2016
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    Last Update Date     |    08/02/2016
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Provider Practice Location Address
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    Address Line         |    670 LINWOOD AVE SUITE 2
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    City                 |    WHITINSVILLE
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    State                |    MA
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    Zip                  |    01588-2068
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    Country              |    US
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    Telephone            |    201-919-0656
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    285 PLANTATION ST APT. 403
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    City                 |    WORCESTER
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    State                |    MA
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    Zip                  |    01604-7701
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    Country              |    US
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    Telephone            |    201-919-0656
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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       |    22426
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    License Number State |    MA
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