Individual
JUSTIN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2321 STOUT RD, MENOMONIE, WI 54751-7003
(715) 233-7740
Mailing address
3807 ROBIN RD, EAU CLAIRE, WI 54703-0445
(715) 456-9344
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1578-39
WI
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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