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Individual

PHILIP DAVID NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
10550 PARK RUN DR, LAS VEGAS, NV 89144-4575
(702) 515-6200
Mailing address
8550 W CHARLESTON BLVD STE 102, LAS VEGAS, NV 89117-9086
(702) 612-7080

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12-1134
NV

Other

Enumeration date
04/11/2022
Last updated
04/11/2022
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