Individual
MARK D NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
104 S 3RD ST W, ADA, MN 56510-1520
(701) 893-5668
Mailing address
104 S 3RD ST W, ADA, MN 56510-1520
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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