Individual
ROBERT DOUGLAS NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
14040 480TH ST, TAMARACK, MN 55787-4429
(218) 426-4518
Mailing address
14040 480TH ST, TAMARACK, MN 55787-4429
(218) 426-4518
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
302246
MN
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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