Individual
MR. JOHN PAUL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
2168 E WILLIAMS FIELD RD, SUITE 108, GILBERT, AZ 85295-0741
(480) 899-9970
(480) 899-9972
Mailing address
5839 E HOPI CIR, MESA, AZ 85206-6780
(480) 833-7073
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2442I
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2442I
OPTICIAN
AZ
Enumeration date
09/27/2010
Last updated
09/27/2010
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