Jack Nelson

NPI #1114140159 in Lebanon, New Hampshire

Provider Information

NPI Number: 1114140159
Entity Type: Individual
Name: Jack Nelson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Adult Companion
Enumeration Date: Apr 10, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 9 HANOVER ST
Address 2: SUITE 2
City: Lebanon
State: New Hampshire
ZIP Code: 03766-1312
Phone: (603) 448-0126

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Adult Companion	372600000X	Primary

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