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1790814200
SUSAN NICKLIN
MEDFORD, OR
NPI
1790814200
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251P0200X Physical Therapist, Pediatrics
(Licence: OR 3217)
Enumeration Date
2007-03-02
Last Update Date
2007-07-08
Business Address
-- SUSAN NICKLIN PT
945 S RIVERSIDE AVE
MEDFORD, OR 97501-7841
Phone number: 541-789-5252
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Mailing Address
-- SUSAN NICKLIN PT
100 E MAIN ST SUITE C
MEDFORD, OR 97501-6041
Phone number: 541-789-5526
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