Individual
HOLLY NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1275 E FAIRFAX RD, SALT LAKE CITY, UT 84103-4324
(801) 536-6310
Mailing address
1275 E FAIRFAX RD, SALT LAKE CITY, UT 84103-4324
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4553579-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4553579-2401
PHYSICAL THERAPY
UT
Enumeration date
06/15/2021
Last updated
06/15/2021
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