Provider Demographics
NPI:1396965802
Name:LONDON, NIKOLE A (MS PT)
Entity type:Individual
Prefix:
First Name:NIKOLE
Middle Name:A
Last Name:LONDON
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1109 W QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110
Mailing Address - Country:US
Mailing Address - Phone:303-781-2314
Mailing Address - Fax:
Practice Address - Street 1:651 POTOMAC ST
Practice Address - Street 2:SUITE A ADVANTAGE THERAPY
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011
Practice Address - Country:US
Practice Address - Phone:303-365-0087
Practice Address - Fax:303-365-0772
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist