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Individual

JEANETTE NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
23999 W 10 MILE RD, SOUTHFIELD, MI 48033-3158
(313) 736-1961
Mailing address
12245 BEECH DALY RD # 40192, REDFORD, MI 48239-5000

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
12/31/2024
Last updated
01/08/2025
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