Individual
JASON RYAN NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 CAMPUS DR, MISSOULA, MT 59812-0003
(608) 287-4077
Mailing address
531 GARNET CT, MISSOULA, MT 59801-7064
(719) 360-6591
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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