Healthcare Provider Details

I. General information

NPI: 1033780424
Provider Name (Legal Business Name): ERIN DANIELLE MCNEIL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 07/07/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 SCOTTSVILLE RD STE 9
BOWLING GREEN KY
42104-3357
US

IV. Provider business mailing address

250 PARK ST
BOWLING GREEN KY
42101-1760
US

V. Phone/Fax

Practice location:
  • Phone: 270-796-6800
  • Fax: 270-781-8228
Mailing address:
  • Phone: 270-745-1015
  • Fax: 270-745-1639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008020
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: