Individual
MICHAEL RICHARD NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
663 W 950 S, BRIGHAM CITY, UT 84302
(435) 734-9449
Mailing address
PO BOX 121, CORINNE, UT 84307-0121
(801) 941-0489
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/02/2018
Last updated
08/03/2018
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