Individual
MITCHELL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S 4TH ST, LOUISVILLE, KY 40203-3205
(502) 779-1763
Mailing address
901 S 4TH ST, LOUISVILLE, KY 40203-3205
(502) 779-1769
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/17/2017
Last updated
04/17/2017
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