Individual
GWENDOLYN A NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT,NCTMB,CLT
Contact information
Practice address
72 FILER ST, MANISTEE, MI 49660-2717
(231) 398-9426
(231) 794-5358
Mailing address
257 LAKESHORE DR N, MANISTEE, MI 49660-1358
(231) 398-9426
(231) 794-5358
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005500
MI
225700000X
Massage Therapist
285249-00
MI
Other
Enumeration date
04/20/2007
Last updated
11/17/2009
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