| NPI | 1235585837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD DAVID NICKLEN President Stom PT Herapy, LLC 850-543-7776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 60420) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-12 |