Provider Demographics
NPI:1194073858
Name:NELSON, LEVI (DC)
Entity type:Individual
Prefix:DR
First Name:LEVI
Middle Name:
Last Name:NELSON
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 WASHINGTON ST N
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3157
Mailing Address - Country:US
Mailing Address - Phone:208-734-0500
Mailing Address - Fax:208-734-0501
Practice Address - Street 1:1015 WASHINGTON ST N
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3157
Practice Address - Country:US
Practice Address - Phone:208-734-0500
Practice Address - Fax:208-734-0501
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor