Individual
BEVERLY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 EMERSON DR, WINDSOR, CT 06095-3204
(860) 640-6338
Mailing address
15 WADDELL RD, MANCHESTER, CT 06040-4715
(860) 646-1052
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01007
CT
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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