Individual
GRETA LOUISE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR
Contact information
Practice address
115 E ARNDT ST, FOND DU LAC, WI 54935-2461
(920) 923-7040
Mailing address
115 E ARNDT ST, FOND DU LAC, WI 54935-2461
(920) 923-7040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5049-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336199520
—
WI
Enumeration date
09/21/2011
Last updated
09/21/2011
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