Individual
RANDALL KENNETH NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
309 PINEWELL DR, NORFOLK, VA 23503-1763
(763) 567-0125
Mailing address
309 PINEWELL DR, NORFOLK, VA 23503-1763
(763) 567-0125
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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