Provider Demographics
NPI:1245397561
Name:JULIE NICHOLS & MICHAEL NICHOLS PTR
Entity Type:Organization
Organization Name:JULIE NICHOLS & MICHAEL NICHOLS PTR
Other - Org Name:GATEWAYS TO HEALING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:513-321-3317
Mailing Address - Street 1:3239 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-2270
Mailing Address - Country:US
Mailing Address - Phone:513-321-3317
Mailing Address - Fax:
Practice Address - Street 1:3239 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2270
Practice Address - Country:US
Practice Address - Phone:513-321-3317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty