Larry Nickelson

NPI #1609254077 in Alva, Oklahoma

Provider Information

NPI Number: 1609254077
Entity Type: Individual
Name: Larry Nickelson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: May 18, 2015
Last Updated: May 18, 2015

Practice Location

Address: 916 NOBLE ST
City: Alva
State: Oklahoma
ZIP Code: 73717-2852
Phone: (888) 873-4221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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