Doctor Name: | MR. JEFF NICHOLL |
NPI Number: | 1437128931 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 17739 |
Business Practice Address: | 516 Las Posas Rd Camarillo, CA - 930105705 |
Business Phone Number: | 8053885678 |
Business Fax Number: | 8053885665 |
Mailing Address: | 516 Las Posas Rd, CAMARILLO |
State: | CA |
Postal Code: | 930105705 |
Phone Number: | 8053885678 |
Fax Number: | 8053885665 |
NPI Enumeration Date: | 03/16/2006 |
NPI Last Update Date: | 03/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 17739 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |