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Jenna St. Nicholas, PTA
NPI 1053891002 · on the registry since 2018 · sole proprietor
Practice
- Address
- 1100 Broadway Blvd
Kilgore, TX 75662 - Phone
- (903) 983-8209
- Clinicians at this address
- 2
Additional practice sites
- 2131 Alpine Rd, Longview, TX
Registry record
- Primary taxonomy
- Physical Therapy Assistant
225200000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-08-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas