Individual
BRIAN RUSSELL NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1211 VIRGINIA ST, GREENSBORO, NC 27401-1313
(336) 275-0927
(336) 275-4834
Mailing address
218 FOUST ST STE C, ASHEBORO, NC 27203-5476
(336) 625-2333
(336) 625-5511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P17693
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
02/01/2018
Last updated
03/08/2024
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