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NPI Code Detail

MEDICARE: MARYLOU F NEAL PTA

MEDICARE:   MARYLOU F NEAL  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant

General Provider Information

NPI Number : 1003946740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYLOU F NEAL PTA
Provider Business Mailing Address
First Line : 2222 SULLIVAN TRL
Second Line :
City : EASTON
State : PA
Zip : 18040-7958
Country : US
Telephone Number : 610-991-2034
Fax Number : 610-438-2046
Provider Business Practice Location Address
First Line : BROOKMONT DRIVE
Second Line :
City : EFFORT
State : PA
Zip : 18330
Country : US
Telephone Number : 610-991-2034
Fax Number : 610-438-2046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/09/2007

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Directions to “ MARYLOU F NEAL PTA” Practice Location

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