Individual
MARY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3860 WACHTEL DRIVE, HOLT, MI 48842
(317) 519-3654
Mailing address
3860 WACHTEL DRIVE, HOLT, MI 48842
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
10/22/2014
Last updated
10/22/2014
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