GARY DALE NICHOLS

FORT LEONARD WOOD, MO
NPI1437140357
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: TX  PA02338)
Enumeration Date2005-10-31
Last Update Date2007-07-08
Business Address
Mr. GARY DALE NICHOLS P.A.-C
16TH STREET CTMC, BLDG 885
FORT LEONARD WOOD, MO 65473
Phone number: 573-596-1680
Mailing Address
Mr. GARY DALE NICHOLS P.A.-C
191 PRIVATE ROAD 845
TEAGUE, TX 75860-6081
Phone number: 254-625-0310
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