Nicklin, Susan
Nicklin, Susan is an individual health care provider with primary practice located at 945 S Riverside Ave , Medford OR 97501-7841. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Nicklin, Susan can be contacted via phone (541) 789-5252.Contact Information
Primary practice address
945 S Riverside Ave
Medford OR 97501-7841
Phone: (541) 789-5252
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | 3217 | Oregon |
Profile Details
| NPI number | 1790814200 |
|---|---|
| LBN Legal business name | Nicklin, Susan |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790814200 | NPPES |
| Oregon | MEDICAID | 183097 |
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