Provider Demographics
NPI:1174094056
Name:OCSON, NELSON C
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:C
Last Name:OCSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N WILMINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-8340
Mailing Address - Country:US
Mailing Address - Phone:910-548-4105
Mailing Address - Fax:
Practice Address - Street 1:304 N WILMINGTON ST
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28574-8340
Practice Address - Country:US
Practice Address - Phone:910-548-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP10112225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist