IndividualActive
Wendy Nichollls, PTA
NPI 1356823058 · Pediatric Rehabilitation Medicine Physician · Royal Oak, MI
Provider details
- NPI number
- 1356823058
- Entity type
- Individual
- Primary specialty
- Pediatric Rehabilitation Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- License
- 5502000828 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone: (248) 655-5660
Fax: (248) 655-5662
Approximate (ZIP-level) locationGet directions
Mailing address
1235 Barneswood Ln
Rochester Hills, MI 48306-4113
Registry dates
- Enumerated
- 2018-08-30
- Last updated
- 2018-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.