MISS Sara Jean Nicholson, PTA

NPI #1508176033 in Circle Pines, Minnesota

Provider Information

NPI Number: 1508176033
Entity Type: Individual
Name: MISS Sara Jean Nicholson, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Oct 18, 2010
Last Updated: Oct 18, 2010

Practice Location

Address: 213 HERITAGE LN
City: Circle Pines
State: Minnesota
ZIP Code: 55014-5007
Phone: (612) 790-3618

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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