Individual
CARL NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 IDAHO ST STE 215, ELKO, NV 89801-3753
(775) 778-9960
Mailing address
405 IDAHO ST STE 215, ELKO, NV 89801-3753
(775) 778-9960
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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