Individual
MR. CRAIG EDWARD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.R
Contact information
Practice address
7TH AND ALBEMARLE ST, PETERSBURG, VA 23803-0030
(804) 524-7107
Mailing address
5718 PROMONTORY PL, MIDLOTHIAN, VA 23112-2075
(804) 304-8453
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000190
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119000190
LICENSE
VA
Enumeration date
03/02/2007
Last updated
06/22/2010
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