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Individual

ASHTON IRVIN NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2848 PLEASANT RD STE 101, FORT MILL, SC 29708-9494
(800) 779-4089
Mailing address
1724 FIRST BAXTER XING, FORT MILL, SC 29708-8919
(803) 322-7475

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P100367E
NC
2251P0200X
Pediatric Physical Therapist
P100367E
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
P100367E
NC
Enumeration date
06/06/2022
Last updated
06/06/2023
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