JOHN ELIOT NICOLAISEN

APPLE VALLEY, CA
NPI1548666738
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: CA  PA52168)
Enumeration Date2014-11-14
Last Update Date2017-09-11
Business Address
-- JOHN ELIOT NICOLAISEN PA
18523 CORWIN RD STE G
APPLE VALLEY, CA 92307-2300
Phone number: 760-242-3376
Mailing Address
-- JOHN ELIOT NICOLAISEN PA
PO BOX 4057
BLUE JAY, CA 92317-4057
Phone number:
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