| Doctor Name: | WADE NIELSON |
| NPI Number: | 1477918084 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT-4276 |
| Business Practice Address: | 355 N Main St Kanab, UT - 847413260 |
| Business Phone Number: | 4356444199 |
| Business Fax Number: | 4356448562 |
| Mailing Address: | 355 N Main St, KANAB |
| State: | UT |
| Postal Code: | 847413260 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/24/2015 |
| NPI Last Update Date: | 12/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-4276 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |