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Individual

JACOB E NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
6699 W RIO GRANDE AVE, KENNEWICK, WA 99336-3301
(509) 460-5588
(509) 783-5438
Mailing address
2839 W KENNEWICK AVE # 550, KENNEWICK, WA 99336-2927
(509) 783-8977
(509) 783-6151

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
WA
2251X0800X
Orthopedic Physical Therapist
WA
261QP2000X
Physical Therapy Clinic/Center
PT60770297
WA

Other

Enumeration date
06/29/2017
Last updated
01/08/2020
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