Individual
MR. PAUL NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA/L
Contact information
Practice address
11 DAIRY LANE, FREDERICKSBURG, VA 22554
(860) 748-2108
Mailing address
102 LAKESEDGE LN, APT. 104, STAFFORD, VA 22554-7509
(860) 748-2108
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
000346
CT
225200000X
Physical Therapy Assistant
0576
NH
225200000X
Physical Therapy Assistant
Primary
2306603748
VA
225200000X
Physical Therapy Assistant
3385
MA
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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