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Individual

JOHANNA NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
16314 CORNUTA AVE, BELLFLOWER, CA 90706-4814
(562) 461-9272
Mailing address
16314 CORNUTA AVE, BELLFLOWER, CA 90706-4814
(562) 461-9272

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
08/21/2018
Last updated
08/21/2018
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