| Doctor Name: | DR. ELISE NICHOLS |
| NPI Number: | 1013316629 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.T |
| License Number: | 21293 |
| Business Practice Address: | 24 Park St Pittsfield, MA - 012014037 |
| Business Phone Number: | 4136291919 |
| Business Fax Number: | |
| Mailing Address: | 24 Park St, PITTSFIELD |
| State: | MA |
| Postal Code: | 012014037 |
| Phone Number: | 4136291919 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2014 |
| NPI Last Update Date: | 08/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 21293 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |