Individual
TIFFANY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 E MILL ST, PELICAN RAPIDS, MN 56572
(218) 286-1140
Mailing address
706 5TH AVE SE, BARNESVILLE, MN 56514-3909
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
850
LICENSE#
MN
Enumeration date
04/17/2007
Last updated
07/08/2007
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