Provider Demographics
NPI:1518852581
Name:NICULAS, ABIGAIL RACHEL (DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:RACHEL
Last Name:NICULAS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 WOODWARD PARK DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2860
Mailing Address - Country:US
Mailing Address - Phone:770-634-8330
Mailing Address - Fax:
Practice Address - Street 1:325 WARNER DR
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-4437
Practice Address - Country:US
Practice Address - Phone:208-798-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016746225100000X
ID1071359225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist