Individual
JACK ORRIN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
19 W NEWTON ST, RICE LAKE, WI 54868-1744
(715) 234-2161
Mailing address
1600 COUNTY ROAD G, SPOONER, WI 54801-8967
(715) 635-9769
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10344-024
WI
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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