Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. BRIAN DAVID NICHOLS, MPT ATC

Active

MR. BRIAN DAVID NICHOLS, MPT ATC is a Physical Therapy Assistant healthcare provider located in STAR, Idaho. NPI 1679679088 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · STAR, ID

Registration Details

NPI Number: 1679679088
Provider Type: Individual
Gender: Male
NPI Issued: Sep 15, 2006 (19.87380543232 yrs)
Last Updated: Jul 2, 2012
Licenses: 1136 (ID)

RPT1136 (ID)

Practice Information

Address: 9652 W STATE STREET

STAR, ID, 836695858
Browse ID providers · Browse ZIP 83669
Phone: 2082860766
Fax: 2082860768
Primary Specialty: Physical Therapy Assistant
225100000X
Additional Specialty: Physical Therapy Assistant

Other Physical Therapy Assistant Providers in STAR, ID

Name	Credential	NPI
LINDSEY E. DECLOSS	M.S.P.T.	1194822528
MRS. JUDIANNE KING NICHOLS	MPT	1184794810
MR. ROBERT W DRISCOLL	PT	1851507099
MRS. DANIELLE-NOELLE D. WUERFEL	DPT	1013106590
CLAYTON TOWNER SHAW	P.T.	1245586270
KRYSIA KRISTINE ROUSSEAU	DPT	1093489601

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.