Individual
MR. CASEY R NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-1100
(801) 587-6340
(801) 587-6346
Mailing address
PO BOX 3208, SALT LAKE CITY, UT 84110-3208
(801) 587-6340
(801) 587-6346
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7331309-1206
UT
363AM0700X
Medical Physician Assistant
004935
GA
Other
Enumeration date
02/13/2007
Last updated
09/01/2010
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