Individual
BOB NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BMS
Contact information
Practice address
210 E SANTA FE AVE, SUITE A, GRANTS, NM 87020-2443
(505) 876-1890
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 338-3320
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/02/2014
Last updated
06/25/2015
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