Provider Demographics
NPI:1740539246
Name:NICHOLS, ERICA JOYCE (DC)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:JOYCE
Last Name:NICHOLS
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 1:6769 COURTLAND DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341
Mailing Address - Country:US
Mailing Address - Phone:616-863-9482
Mailing Address - Fax:616-863-9486
Practice Address - Street 1:6769 COURTLAND DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341
Practice Address - Country:US
Practice Address - Phone:616-863-9482
Practice Address - Fax:616-863-9486
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor