Individual
NADINE AVE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5761 WELLS CIRCLE, PRVT, STONE MTN, GA 30087-3008
(470) 782-2371
Mailing address
5761 WELLS CIR, STONE MOUNTAIN, GA 30087-6007
(470) 782-2371
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT007938
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5520
—
GA
05
—
5520
—
NY
Enumeration date
02/03/2021
Last updated
02/03/2021
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