Organization
NEBO FOOT & ANKLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L NELSON DPM (OWNER)
(801) 794-3856
Entity
Organization
Contact information
Practice address
65 W 200 N, SUITE 1, SPANISH FORK, UT 84660-1756
(801) 794-3856
(801) 794-9882
Mailing address
65 W 200 N STE 5, SPANISH FORK, UT 84660-1774
(801) 794-3856
(801) 794-9882
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
367775-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528373359001
—
UT
Enumeration date
06/21/2007
Last updated
05/20/2020
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