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General NPI Number Information
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NPI Number | 1508013558
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Entity Type | Organization
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Legal Business Name | LYNN NELSON DC PC
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 285 EAST 100 SOUTH
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City | VERNAL
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State | UT
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Zip | 84078-0000
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Country | US
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Telephone | 435-789-4483
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Fax | 435-789-4488
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Provider Business Mailing Address
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Address Line | 258 E 100 S
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City | VERNAL
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State | UT
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Zip | 84078-0000
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Country | US
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Telephone | 435-789-4483
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Fax | 435-789-4488
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Authorized Official
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Title or Position | OWNER
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Name | DR. W LYNN NELSON
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Credential | DC PC
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Telephone | 435-789-4483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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