Provider Demographics
NPI:1326483694
Name:NICHOLS-AUSTIN, TAMARA CHAPELL (DC)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:CHAPELL
Last Name:NICHOLS-AUSTIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 NE MIAMI GARDENS DRIVE
Mailing Address - Street 2:ACCIDENT AND INJURY CENTER
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179
Mailing Address - Country:US
Mailing Address - Phone:305-947-9300
Mailing Address - Fax:305-947-5640
Practice Address - Street 1:1728 NE MIAMI GARDENS DRIVE
Practice Address - Street 2:ACCIDENT AND INJURY CENTER
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179
Practice Address - Country:US
Practice Address - Phone:305-947-9300
Practice Address - Fax:305-947-5640
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor