Provider Demographics
NPI:1588267421
Name:SAUL, NICOLE (PT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SAUL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2472 N PANTANO RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3743
Mailing Address - Country:US
Mailing Address - Phone:520-722-1795
Mailing Address - Fax:520-722-1047
Practice Address - Street 1:2472 N PANTANO RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3743
Practice Address - Country:US
Practice Address - Phone:520-722-1795
Practice Address - Fax:520-722-1047
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3561225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist