Provider Demographics
NPI:1134192503
Name:NELSON, AARON M (MS, ATC-L, PES)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:M
Last Name:NELSON
Suffix:
Gender:M
Credentials:MS, ATC-L, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 S TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-2673
Mailing Address - Country:US
Mailing Address - Phone:480-659-7101
Mailing Address - Fax:602-379-7549
Practice Address - Street 1:201 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2412
Practice Address - Country:US
Practice Address - Phone:602-379-7968
Practice Address - Fax:602-379-7549
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0028174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist