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NPI Code Detail

MEDICARE: NICOLE WU ATC

MEDICARE:   NICOLE  WU  ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
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General Provider Information

NPI Number : 1023567948
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE WU ATC
Provider Business Mailing Address
First Line : 4015 SPRING MILL PL
Second Line :
City : LOUISVILLE
State : KY
Zip : 40245-7474
Country : US
Telephone Number : 502-802-4940
Fax Number :
Provider Business Practice Location Address
First Line : 9115 FERN CREEK RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40291-2799
Country : US
Telephone Number : 502-485-8251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2016
Last Update Date : 08/20/2023

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Directions to “ NICOLE WU ATC” Practice Location

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