Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 22664 | CA |
NPI | 1134574031 |
---|---|
Provider Name | Dr. Rhonda Nichelle Nelson |
First Address | Redlands, CA 92374-0110 |
Second Address | Redlands, CA 92374-0110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2016 |
Last Update Date | 20/12/2021 |