Provider Demographics
NPI:1518497320
Name:NELSON, AARON JAMES (PT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:JAMES
Last Name:NELSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W5282 AMY AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-7233
Mailing Address - Country:US
Mailing Address - Phone:920-831-5050
Mailing Address - Fax:920-358-1990
Practice Address - Street 1:W5282 AMY AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-7233
Practice Address - Country:US
Practice Address - Phone:920-831-5050
Practice Address - Fax:920-358-1990
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist