Nicklas Lidstrom
NPI #1871369603 in Conway, South Carolina
Provider Information
- NPI Number
- 1871369603
- Entity Type
- Individual
- Name
- Nicklas Lidstrom
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Enumeration Date
- Dec 4, 2023
- Last Updated
- Dec 4, 2023
Practice Location
- Address
- 925 ONE LANDON LOOP
- City
- Conway
- State
- South Carolina
- ZIP Code
- 29528
- Phone
- (843) 349-2825
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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