Individual
AMANDA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Mailing address
1392 SHADYWOOD LN, WACONIA, MN 55387-1179
(507) 456-7557
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A47
MN
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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