Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Corey Phillips Nickerson

Individual provider Physical Therapist · NPI 1508419219

Corey Phillips Nickerson is a Physical Therapist in San Antonio, Texas. Licensed in Texas. Registered with an NPI since 2019.

Licensed in
TX
In the registry since
2019

Practice location Address checks out

1100 Wilford Hall Loop Jbsa Lackland Afb
San Antonio, TX 78236
Phone: (210) 292-5034
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1322584 (TX)

Record details

NPI number1508419219
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 22, 2019
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026

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