Individual
ERIC E NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, OCS
Contact information
Practice address
92 MAIN ST, TIBURON, CA 94920-2508
(415) 435-7488
Mailing address
92 MAIN ST, TIBURON, CA 94920-2508
(415) 435-7488
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT25508
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ22814Z
MEDICARE PTAN
CA
Enumeration date
08/24/2006
Last updated
11/06/2013
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