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Individual

BRAD LESTER NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC-L

Contact information

Practice address
162 W 100 S, LOGAN HIGH SCHOOL, LOGAN, UT 84321-5229
(435) 755-2380
(435) 755-2387
Mailing address
4865 HOLLOW RD, LOGAN, UT 84321-7966
(435) 245-0478

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2378103-4810
UT

Other

Enumeration date
12/29/2006
Last updated
07/08/2007
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