Individual
MR. MICHAEL KENNETH NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED, ATC, CSCS
Contact information
Practice address
56 BARBER AVE, WARWICK, RI 02886-5202
(401) 921-2594
Mailing address
56 BARBER AVE, WARWICK, RI 02886-5202
(401) 921-2594
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
2255A2300X
Athletic Trainer
Primary
1407
MA
2255A2300X
Athletic Trainer
AT00194
RI
Other
Enumeration date
01/03/2007
Last updated
09/11/2025
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