Individual
LYNN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2099 GRAND ISLAND BLVD STE B, GRAND ISLAND, NY 14072-2266
(716) 773-3300
Mailing address
2099 GRAND ISLAND BLVD STE B, GRAND ISLAND, NY 14072-2266
(716) 773-3300
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1399404
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1399404
LICENSE
NY
Enumeration date
11/10/2022
Last updated
11/10/2022
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