Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1396925368 |
---|---|
Provider Name | David P Nelson |
First Address | St Paul, MN 55102 |
Second Address | St Paul, MN 55102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 22/01/2009 |