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1073011243
WILLIE NICHOLSON
LOS ANGELES, CA
NPI
1073011243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2018-01-23
Last Update Date
2018-05-29
Business Address
WILLIE NICHOLSON
6957 N FIGUEROA ST
LOS ANGELES, CA 90042
Phone number: 323-443-3175
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Mailing Address
WILLIE NICHOLSON
1945 HILLHURST AVE APT 2
LOS ANGELES, CA 90027-2732
Phone number: 618-660-9464
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