PHILIP RAY NICKOLS

MACOMB, IL
NPI1407370729
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096.003810)
Enumeration Date2017-07-28
Last Update Date2022-07-21
Business Address
PHILIP RAY NICKOLS
1 UNIVERSITY CIR
MACOMB, IL 61455
Phone number: 309-298-2138
Mailing Address
PHILIP RAY NICKOLS
1 UNIVERSITY CIR
MACOMB, IL 61455-1367
Phone number: 309-298-2138
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