Provider Demographics
NPI:1427086644
Name:RAYMOND, NICOLE A (PT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:A
Other - Last Name:SALTZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3734 E ENCINAS AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2920
Mailing Address - Country:US
Mailing Address - Phone:602-228-4382
Mailing Address - Fax:
Practice Address - Street 1:3734 E ENCINAS AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2920
Practice Address - Country:US
Practice Address - Phone:602-228-4382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24810225100000X
NY020219225100000X
AZ6299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist