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Individual
CORY NELSON
Active
Individual
CORY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
8591638-1204
UT
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
8591638-1204
UT
208D00000X
General Practice Physician
5101018672
MI
Other
Enumeration date
07/01/2010
Last updated
09/08/2021
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