Nickelson, Kelly L

Nickelson, Kelly L is an individual health care provider with primary practice located at 401 Gaylord Dr , Fulton MO 65251-2517. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Nickelson, Kelly L can be contacted via phone (573) 642-8541.

Contact Information

Primary practice address
401 Gaylord Dr Fulton MO 65251-2517
Phone: (573) 642-8541
Fax: (573) 642-8500
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 2002015010 Missouri
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2002015010 Missouri

Profile Details

NPI number 1871780155
LBN Legal business name Nickelson, Kelly L
Credentials PHYSICAL THERAPIST
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2007
Last updated Apr 19th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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