Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICCOLE J MACK, D.P.T.
ActivePhysical Therapy Assistant · WATERTOWN, SD
Registration Details
- NPI Number
- 1063401503
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 18, 2005 (20.517321574766 yrs)
- Last Updated
- Nov 5, 2013
- License
-
1225 (SD)
Practice Information
- Address
-
901 4TH ST NWWATERTOWN, SD, 572011558Browse SD providers · Browse ZIP 57201
- Phone
- 6058868471
- Fax
- 6058869317
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in WATERTOWN, SD
| Name | Credential | NPI |
|---|---|---|
| MR. NATHAN LEE BRESKE | DPT, ATC | 1235135765 |
| CHAD LAVERNE LAUSENG | P.T. | 1336146398 |
| MICHAEL D PESEK | PT, ATC | 1710973193 |
| TYANNE L LUKEN | PT | 1477532976 |
| MS. MICHELLE MARIE MCCORMICK | PT | 1972560761 |
| LYNN SIMON | P.T. | 1306871165 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.