| Doctor Name: | MICHAEL NIETLING |
| NPI Number: | 1528420288 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 5168 |
| Business Practice Address: | 105 N 5th Ave Madill, OK - 734461200 |
| Business Phone Number: | 5807953301 |
| Business Fax Number: | 5807957307 |
| Mailing Address: | Po Box 831, MADILL |
| State: | OK |
| Postal Code: | 734460831 |
| Phone Number: | 5807953301 |
| Fax Number: | 5807957307 |
| NPI Enumeration Date: | 03/22/2016 |
| NPI Last Update Date: | 03/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5168 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| 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 |