Doctor Name: | DR. PHILLIP NICOLAS |
NPI Number: | 1083747810 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 03382 |
Business Practice Address: | 10630 Little Patuxent Pkwy Ste. 116 Columbia, MD - 210446208 |
Business Phone Number: | 4109927730 |
Business Fax Number: | |
Mailing Address: | 10630 Little Patuxent Pkwy, Ste. 116 COLUMBIA |
State: | MD |
Postal Code: | 210446208 |
Phone Number: | 4109927730 |
Fax Number: | |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 10/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 03382 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |