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Individual

WAYNE S NIELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
355 N MAIN ST, KANAB, UT 84741-3260
(435) 644-4179
(435) 644-3588
Mailing address
355 N MAIN ST, KANAB, UT 84741-3260
(435) 644-4179
(435) 644-3588

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4893858-1206
UT

Other

Enumeration date
10/23/2009
Last updated
10/23/2009
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