| Doctor Name: | NIKKI POOLE |
| NPI Number: | 1629244017 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PTA |
| License Number: | 06001474 |
| Business Practice Address: | 9909 E 100 S Greentown, IN - 469369163 |
| Business Phone Number: | 7656280605 |
| Business Fax Number: | 7656283639 |
| Mailing Address: | 9909 E 100 S, GREENTOWN |
| State: | IN |
| Postal Code: | 469369163 |
| Phone Number: | 7656280605 |
| Fax Number: | 7656283639 |
| NPI Enumeration Date: | 05/05/2008 |
| NPI Last Update Date: | 05/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 06001474 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |