Individual
KELLY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
915 HORTON ST, FORT SCOTT, KS 66701-2437
(615) 896-6400
Mailing address
915 215TH ST, FORT SCOTT, KS 66701-8734
(620) 223-5349
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1401554
KS
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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