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Contact Information

NICOLE ANDERSON
928 MAR WALT DRIVE
STE 104
FORT WALTON BEACH, FL32547
 Phone: 850-863-4747
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for NICOLE ANDERSON · (Female)

NPI # 1013024595
Status Active
Credentials
Entity Individual
Enumeration date 08/23/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • FL Other PT22005 LICENSE #
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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