Provider Demographics
NPI:1376026872
Name:WOLFE, NIKOLA
Entity Type:Individual
Prefix:
First Name:NIKOLA
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 INDUSTRIAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3178
Mailing Address - Country:US
Mailing Address - Phone:603-882-4500
Mailing Address - Fax:
Practice Address - Street 1:20 INDUSTRIAL PARK DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3178
Practice Address - Country:US
Practice Address - Phone:603-882-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist