Basic Information
| Provider Information | |||||||||
| NPI: | 1104334499 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UHL | ||||||||
| FirstName: | NICHOLAS | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3704 QUAIL HOLLOW CT | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402416215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028516605 | ||||||||
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| Practice Location | |||||||||
| Address1: | 520 S EAGLE RD | ||||||||
| Address2: | |||||||||
| City: | MERIDIAN | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836426351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2087065000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2018 | ||||||||
| LastUpdateDate: | 01/20/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT-5525 | ID | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.