Greg Neilsen, OTR/L

Individual provider Active NPI Occupational Therapist · Roosevelt, UT

NPI 1154748010 · NPPES record last updated Mar 27, 2014

Key facts

NPI
1154748010
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
8695051-4201 (UT)
Practice address
250 W 300 N
Roosevelt, UT 84066-2336
Phone
(435) 722-6186
NPI assigned
Mar 27, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8695051-4201UTMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8695051-4201 UT Yes

Addresses

Primary practice location

250 W 300 N
Roosevelt, UT 84066-2336

Mailing address

250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-6186

Other providers in Roosevelt, UT

All providers in Roosevelt, UT · Occupational Therapist in Utah

Sources for this page

Verify at the official NPI Registry.