Jenna Marie St. Nicholas, PTA

NPI #1053891002 in Kilgore, Texas

Provider Information

NPI Number
1053891002
Entity Type
Individual
Name
Jenna Marie St. Nicholas, PTA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physical Therapy Assistant
Credential
PTA
Enumeration Date
Aug 20, 2018
Last Updated
Aug 20, 2018

Practice Location

Address
1100 BROADWAY BLVD
State
Texas
ZIP Code
75662-3204
Phone
(903) 983-8209

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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