MEDICARE: CLAUDIA MCNEILL PT

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	225100000X	Physical Therapist	4960 PT	SC
2	225100000X	Physical Therapist	PT 002675	GA

General Provider Information

NPI Number	:	1942691068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA MCNEILL PT

Provider Business Mailing Address
First Line	:	1307 HORSESHOE BND
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-7406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1307 HORSESHOE BND
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-7406
Country	:	US
Telephone Number	:	912-856-2215
Fax Number	:

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

Provider Enumeration Date	:	02/11/2015
Last Update Date	:	02/11/2015

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