Individual
MRS. DIANNE DENISE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1130 ALLUMBAUGH ST, BOISE, ID 83704-8700
(208) 854-8517
Mailing address
6199 N BUCKLEY PL, BOISE, ID 83713-1202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1193
ID
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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