Individual
TANNER NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, PT
Contact information
Practice address
2310 BALE ST, RALEIGH, NC 27608-1771
(919) 364-4000
Mailing address
2310 BALE ST, RALEIGH, NC 27608-1771
(919) 364-4000
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P22332
NC
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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