Healthcare Provider Details

I. General information

NPI: 1245688225
Provider Name (Legal Business Name): CHAD NEAL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N SAGINAW RD STE C
MIDLAND MI
48640-2690
US

IV. Provider business mailing address

2600 N SAGINAW RD STE C
MIDLAND MI
48640-2690
US

V. Phone/Fax

Practice location:
  • Phone: 989-837-1529
  • Fax: 989-837-2499
Mailing address:
  • Phone: 989-837-1529
  • Fax: 989-837-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501017716
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: