Provider Demographics
NPI:1205003662
Name:NELSON, SETH R (DC)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:R
Last Name:NELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082
Mailing Address - Country:US
Mailing Address - Phone:507-351-3313
Mailing Address - Fax:
Practice Address - Street 1:1520 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082
Practice Address - Country:US
Practice Address - Phone:507-934-3333
Practice Address - Fax:844-274-1492
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor