Individual
ALLEN LOYD NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
(208) 535-1286
Mailing address
1460 ELK CREEK DR, IDAHO FALLS, ID 83404-8237
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6761669
ID
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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