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General NPI Number Information
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NPI Number | 1437713872
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Entity Type | Individual
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Provider Name | DANIEL ERIC NELSON ATC
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Gender | Male
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 575 N SIOUX POINT RD
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5312
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Country | US
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Telephone | 712-490-6909
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Fax |
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Provider Business Mailing Address
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Address Line | 3033 KENSINGTON CT
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City | SIOUX CITY
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State | IA
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Zip | 51104-2818
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Country | US
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Telephone | 712-490-6909
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 00230
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License Number State | IA
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