Individual
KAYTLIN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1037 21ST ST, LEWISTON, ID 83501-3415
(208) 743-1795
(208) 743-1791
Mailing address
1037 21ST ST, LEWISTON, ID 83501-3415
(208) 743-1795
(208) 743-1791
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4953
ID
Other
Enumeration date
01/30/2017
Last updated
01/30/2017
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