Provider Demographics
NPI:1518423334
Name:NICHOLS, RAYMOND LOUIS JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LOUIS
Last Name:NICHOLS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 POWERS FERRY RD SE APT E
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5265
Mailing Address - Country:US
Mailing Address - Phone:601-323-2003
Mailing Address - Fax:
Practice Address - Street 1:996 BATESVILLE RD STE 7
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-6825
Practice Address - Country:US
Practice Address - Phone:864-605-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor