Individual
JOSHUA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
7610 PERSHING BLVD, KENOSHA, WI 53142-4318
(262) 948-3600
Mailing address
7610 PERSHING BLVD, KENOSHA, WI 53142-4318
(262) 948-3600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13458-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40252000
—
WI
Enumeration date
08/03/2016
Last updated
08/15/2016
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