| Doctor Name: | NICHOLE L NOVAK |
| NPI Number: | 1770797896 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5501011297 |
| Business Practice Address: | 9249 W Lake City Rd Houghton Lake, MI - 486299602 |
| Business Phone Number: | 9898393221 |
| Business Fax Number: | |
| Mailing Address: | 301 Clearwater Avenue, Po Box 124 PRUDENVILLE |
| State: | MI |
| Postal Code: | 48651 |
| Phone Number: | 3137026424 |
| Fax Number: | |
| NPI Enumeration Date: | 05/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501011297 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| 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 |