Provider Demographics
NPI:1265539183
Name:NICHOLS, DORIS C (PT , MA)
Entity type:Individual
Prefix:MRS
First Name:DORIS
Middle Name:C
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:PT , MA
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Mailing Address - Street 1:696 STODDARD MILL RD
Mailing Address - Street 2:
Mailing Address - City:GRAY COURT
Mailing Address - State:SC
Mailing Address - Zip Code:29645-3832
Mailing Address - Country:US
Mailing Address - Phone:864-862-3700
Mailing Address - Fax:
Practice Address - Street 1:719 SE MAIN ST
Practice Address - Street 2:SSI PHYSICAL THERAPY
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3237
Practice Address - Country:US
Practice Address - Phone:864-963-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist