Healthcare Provider Details

I. General information

NPI: 1740104892
Provider Name (Legal Business Name): JOSEPH O'NEILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 28TH AVE SW STE 2
ALTOONA IA
50009-3940
US

IV. Provider business mailing address

1704 MLK JR PKWY
DES MOINES IA
50314-1450
US

V. Phone/Fax

Practice location:
  • Phone: 515-446-2075
  • Fax:
Mailing address:
  • Phone: 712-389-5796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: