Individual
JUSTIN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L, LAT, ATC
Contact information
Practice address
1415 W MOUND RD, DECATUR, IL 62526-1263
(217) 615-3741
Mailing address
1536 S DOUGLAS AVE, SPRINGFIELD, IL 62704-3516
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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