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Individual

MR. MARK WILLIAM NILSSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.S. BC-HIS

Contact information

Practice address
1770 RED CLIFFS DR, 214, ST GEORGE, UT 84790-8144
(435) 628-3192
(435) 628-2237
Mailing address
1770 RED CLIFFS DR, 214, ST GEORGE, UT 84790-8144
(435) 628-3192
(435) 628-2237

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1012074601
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870429766000
UT
Enumeration date
09/08/2008
Last updated
07/01/2014
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