Individual
MICHAEL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4719 COOPER ST, ALBANY, GA 31705-6009
(229) 395-1739
Mailing address
4719 COOPER ST, ALBANY, GA 31705-6009
(229) 395-1739
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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