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1104367267
TRAVIS NICHOLAS
NEWARK, OH
NPI
1104367267
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-03-09
Last Update Date
2017-03-09
Business Address
-- TRAVIS NICHOLAS QMHS
65 MESSIMER DR
NEWARK, OH 43055-1874
Phone number: 740-504-2563
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Mailing Address
-- TRAVIS NICHOLAS QMHS
65 MESSIMER DR
NEWARK, OH 43055-1874
Phone number: 740-504-2563
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