| NPI | 1154842136 |
|---|---|
| Other Name | JAKE NELSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: WA PT60770297) |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2020-01-08 |