Individual
AVERY ROSS NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2106 HERITAGE OAKS CT, FLEMING ISLAND, FL 32003-5300
(904) 327-3469
Mailing address
2106 HERITAGE OAKS CT, FLEMING ISLAND, FL 32003-5300
(904) 327-3469
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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