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General NPI Number Information
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NPI Number | 1134210867
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Entity Type | Individual
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Provider Name | DAVID NIELSEN
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 505 W HOLLIS ST STE 104
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City | NASHUA
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State | NH
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Zip | 03062-1386
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Country | US
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Telephone | 603-886-2710
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Fax |
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Provider Business Mailing Address
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Address Line | 68 CIRCUIT DR
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City | STOW
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State | MA
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Zip | 01775-1373
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Country | US
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Telephone | 978-897-5314
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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