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MITCHELL GORDON NIELSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
573 AMBOY AVE, WOODBRIDGE, NJ 07095-3049
(908) 282-3737
Mailing address
344 HULSE AVE, BRICK, NJ 08724-1516
(412) 952-0019

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00295300
NJ

Other

Enumeration date
05/22/2020
Last updated
05/22/2020
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