Provider Demographics
NPI:1851858443
Name:NELSON-BOCK, NANCY 50743
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:50743
Last Name:NELSON-BOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55333-0023
Mailing Address - Country:US
Mailing Address - Phone:507-430-2610
Mailing Address - Fax:
Practice Address - Street 1:900 3RD ST S
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MN
Practice Address - Zip Code:55333-9799
Practice Address - Country:US
Practice Address - Phone:507-557-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA768225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant