| Jeannise Marie Nichols, OT | |
|
2021 E Village Green Cir Ste C, Draper, UT 84020-5500 | |
| (801) 440-5592 | |
| Not Available |
| Full Name | Jeannise Marie Nichols |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 2021 E Village Green Cir Ste C, Draper, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124709498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 24261 (California) | Primary |
| Provider Name | Wheelchair Clinic Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265904064 PECOS PAC ID: 0941613590 Enrollment ID: O20230303001496 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeannise Marie Nichols, OT 2021 E Village Green Cir Ste C, Draper, UT 84020-5500 Ph: (801) 440-5592 | Jeannise Marie Nichols, OT 2021 E Village Green Cir Ste C, Draper, UT 84020-5500 Ph: (801) 440-5592 |
Kaylyn Ellis, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12453 S 265 W Ste B, Draper, UT 84020 Phone: 801-443-7775 Fax: 801-447-0107 | |
Kari Armstrong, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12453 S 265 W Ste B, Draper, UT 84020 Phone: 801-443-7775 Fax: 801-447-0107 | |
Emma Christman, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12453 S 265 W Ste B, Draper, UT 84020 Phone: 801-443-7775 Fax: 801-447-0107 | |
Jessica Goethals, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12453 S 265 W Ste B, Draper, UT 84020 Phone: 801-443-7775 Fax: 801-447-0107 | |
Kassidy Lien Ha, MOTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12453 S 265 W Ste B, Draper, UT 84020 Phone: 801-443-7775 Fax: 801-447-0107 | |
Alysha Koster, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 12453 S 265 W Ste B, Draper, UT 84020 Phone: 801-443-7775 |