Individual
DOUGLAS MICHAEL NELSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
6200 140TH ST W, APPLE VALLEY, MN 55124-3328
(952) 431-8948
(952) 431-8911
Mailing address
10039 JAMES CIR, BLOOMINGTON, MN 55431-3008
(952) 884-1451
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1094
MN
Other
Enumeration date
02/23/2006
Last updated
07/08/2007
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