Individual
THERESA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11594 CONOVER RD, VERSAILLES, OH 45380-8423
(937) 564-7424
Mailing address
11594 CONOVER RD, VERSAILLES, OH 45380-8423
(937) 564-7424
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8344
OH
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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