MRS. Judianne King Nichols, MPT

NPI #1184794810 in Star, Idaho

Provider Information

NPI Number: 1184794810
Entity Type: Individual
Name: MRS. Judianne King Nichols, MPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MPT
Enumeration Date: Nov 9, 2006
Last Updated: Jul 2, 2012

Practice Location

Address: 9652 W STATE STREET
City: Star
State: Idaho
ZIP Code: 83669-5858
Phone: (208) 286-0766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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