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1316936156
GARY GLENN NICHOLS
NORTH WILKESBORO, NC
NPI
1316936156
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NC 100253)
Enumeration Date
2005-10-14
Last Update Date
2017-08-01
Business Address
-- GARY GLENN NICHOLS P.A.
1404 WILLOW LN
NORTH WILKESBORO, NC 28659-3584
Phone number: 336-667-0335
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Mailing Address
-- GARY GLENN NICHOLS P.A.
PO BOX 602658
CHARLOTTE, NC 28260-2658
Phone number: 336-716-2011
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