Individual
SAMANTHA MARIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAC
Contact information
Practice address
1970 S RIDGE RD, GREEN BAY, WI 54304-4125
(920) 430-4888
Mailing address
9857 BONEY FALLS H RD, CORNELL, MI 49818-9528
(906) 399-0233
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002813
MI
Other
Enumeration date
08/28/2020
Last updated
10/05/2022
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