Nancy P. Nichols, RPT

Individual provider Active NPI Physical Therapist · Milaca, MN

NPI 1376629295 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376629295
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
4146 (MN)
Practice address
1142 Bear St
Milaca, MN 56353-3948
Phone
(763) 389-6420
Fax
(763) 389-6410
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4146MNMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4146 MN Yes

Addresses

Primary practice location

1142 Bear St
Milaca, MN 56353-3948

Mailing address

1142 Bear St
Milaca, MN 56353-3948
Phone (763) 389-6422

Other providers in Milaca, MN

All providers in Milaca, MN · Physical Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.