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1114261310
KIM A NICHOLS
PORT ORANGE, FL
NPI
1114261310
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: KY A4194)
Enumeration Date
2012-11-12
Last Update Date
2012-11-12
Business Address
KIM A NICHOLS
5535 S WILLIAMSON BLVD STE 774
PORT ORANGE, FL 32128-8311
Phone number: 800-330-7711
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Mailing Address
KIM A NICHOLS
111 OSBORNE LN
MADISONVILLE, KY 42431-9766
Phone number:
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