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1740400407
STEPHEN MICHAEL NICKELL
CAPE GIRARDEAU, MO
NPI
1740400407
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2012028530)
Enumeration Date
2007-04-26
Last Update Date
2014-04-04
Business Address
Mr. STEPHEN MICHAEL NICKELL M.A., ATC
1 UNIVERSITY PLZ MS 7650
CAPE GIRARDEAU, MO 63701-4710
Phone number: 573-986-6841
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Mailing Address
Mr. STEPHEN MICHAEL NICKELL M.A., ATC
2142 KENNETH DR
CAPE GIRARDEAU, MO 63701-1863
Phone number: 937-631-4660
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