| NPI Details | |
|---|---|
| NPI | 1063409852 |
| Gender | Male |
| Enumeration Date | 10/05/2005 |
| Last Updated | 02/29/2012 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 1244 WISCONSIN AVE SUITE 303 RACINE WI, 53403-1987, US |
|
| Phone | (262) 635-5520 |
| Fax | (262) 635-5530 |
| Business Location | |
|---|---|
| 1244 WISCONSIN AVE SUITE 303 RACINE WI, 53403-1987, US |
|
| Phone | (262) 635-5520 |
| Fax | (262) 635-5530 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 103TC1900X |
| License State | Wisconsin |
| License Number | 943-057 |
| Remove 1063409852 NPI Number | |
According to our database, David L Nichols PHD NPI is 1063409852, taxonomy code is 103TC1900X and license number is 943-057, license state is located at Wisconsin. David L Nichols PHD physically located at 1244 Wisconsin Ave, Racine WI, 53403-1987. NPI Number David L Nichols PHD has the Individual type.
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1063409852 NPI number is provided on an as is basis without warranty of any kind. 1063409852 is maintained by the National Plan & Provider Enumeration System. The contents of David L Nichols PHD are for informational purposes only.
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