MEDICARE: DR. NICKCOLD SAVOIR NICHOLSON DC

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
1	111N00000X	Chiropractor	CHIR010592	GA
2	111N00000X	Chiropractor	CH14025	FL

General Provider Information

NPI Number	:	1205581782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICKCOLD SAVOIR NICHOLSON DC

Provider Business Mailing Address
First Line	:	840 ERNEST W BARRETT PKWY NW UNIT 440521
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30160-0105
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5329 W COLONIAL DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-7607
Country	:	US
Telephone Number	:	407-730-3980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	11/09/2022

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Directions to “ DR. NICKCOLD SAVOIR NICHOLSON DC” Practice Location

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