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Individual
MR. MICHAEL KENNETH NELSON
Active
Individual
MR. MICHAEL KENNETH NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED, ATC, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
2255A2300X
Athletic Trainer
Primary
1407
MA
2255A2300X
Athletic Trainer
AT00194
RI
Other
Enumeration date
01/03/2007
Last updated
09/11/2025
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