Provider Demographics
NPI:1306988985
Name:NELSON, WILEY F (NCTMB, MTPT)
Entity type:Individual
Prefix:MR
First Name:WILEY
Middle Name:F
Last Name:NELSON
Suffix:
Gender:M
Credentials:NCTMB, MTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145-1137
Mailing Address - Country:US
Mailing Address - Phone:412-825-0777
Mailing Address - Fax:
Practice Address - Street 1:625 BROWN AVE
Practice Address - Street 2:
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145-1137
Practice Address - Country:US
Practice Address - Phone:412-825-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist