Individual
ERIC MATHEW NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
6246 SO REDWOOD RD, AVALON BENNION CARE CENTER, SLC, UT 84123
(801) 955-0690
(801) 955-2540
Mailing address
6246 SO REDWOOD RD, AVALON BENNION CARE CENTER, SLC, UT 84123
(801) 955-0690
(801) 955-2540
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3481244201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D4617
—
UT
Enumeration date
11/17/2006
Last updated
07/08/2007
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