Provider Demographics
NPI:1679846331
Name:NELSON, JOSEPH C (DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:NELSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 N DODGE ST STE B
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-8304
Mailing Address - Country:US
Mailing Address - Phone:193-246-2006
Mailing Address - Fax:319-483-6919
Practice Address - Street 1:2400 N DODGE ST STE B
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-8304
Practice Address - Country:US
Practice Address - Phone:319-246-2006
Practice Address - Fax:319-483-6919
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist