Individual
DIANE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3925 SHERIDAN DR, AMHERST, NY 14226-1738
(716) 250-9999
Mailing address
203 FAIRVALE RD, CHEEKTOWAGA, NY 14225-2262
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000134
NY
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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