| Doctor Name: | MRS. ROXANN E. NICKERSON |
| NPI Number: | 1023299922 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 1112 |
| Business Practice Address: | 6 Hampton Ln Andover, MA - 018104302 |
| Business Phone Number: | 9784754450 |
| Business Fax Number: | |
| Mailing Address: | 6 Hampton Ln, ANDOVER |
| State: | MA |
| Postal Code: | 018104302 |
| Phone Number: | 9784754450 |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2007 |
| NPI Last Update Date: | 11/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 1112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |