Individual
WADE NIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
355 N MAIN ST, KANAB, UT 84741-3260
(435) 644-4199
(435) 644-8562
Mailing address
355 N MAIN ST, KANAB, UT 84741-3260
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-4276
ID
Other
Enumeration date
12/24/2015
Last updated
12/24/2015
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