Basic Information
| Provider Information | |||||||||
| NPI: | 1093073918 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NELSON-VELTKAMP | ||||||||
| FirstName: | KRISTEN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17350 PARKSIDE DR | ||||||||
| Address2: | |||||||||
| City: | NORTH ROYALTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441335400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797139824 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7766 BROADVIEW RD | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441346743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642443626 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT016714 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.