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1295761930
BRIAN J NICKERSON
ORLANDO, FL
NPI
1295761930
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL AL 96)
Enumeration Date
2006-06-24
Last Update Date
2007-07-08
Business Address
-- BRIAN J NICKERSON ATC
100 W GORE ST SUITE 204
ORLANDO, FL 32806-1044
Phone number: 407-835-8818
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Mailing Address
-- BRIAN J NICKERSON ATC
130 AVERY LAKE DR
WINTER SPRINGS, FL 32708-5191
Phone number: 407-971-1883
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