MEDICARE: MR. MICHAEL ALAN NEUENDORFF RRT, RPFT

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
1	2279E1000X	Educational Registered Respiratory Therapist	RCP 1458	OH
2	2279P1004X	Pulmonary Diagnostics Registered Respiratory Therapist	RCP 1458	OH
3	2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	RCP 1458	OH

General Provider Information

NPI Number	:	1477843654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL ALAN NEUENDORFF RRT, RPFT

Provider Business Mailing Address
First Line	:	9906 NORWALK RD
Second Line	:
City	:	LITCHFIELD
State	:	OH
Zip	:	44253-9502
Country	:	US
Telephone Number	:	330-721-4747
Fax Number	:	330-721-0726

Provider Business Practice Location Address
First Line	:	9906 NORWALK RD
Second Line	:
City	:	LITCHFIELD
State	:	OH
Zip	:	44253-9502
Country	:	US
Telephone Number	:	330-721-4747
Fax Number	:	330-721-0726

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2011
Last Update Date	:	04/09/2011

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