Individual
EMMA LEIGH NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16647 TOWNHOUSE RD, NEWARK, IL 60541-9219
(815) 666-4492
Mailing address
16647 TOWNHOUSE RD, NEWARK, IL 60541-9219
(815) 666-4492
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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