Healthcare Provider Details

I. General information

NPI: 1083534663
Provider Name (Legal Business Name): TIMOTHY NEAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5776 RUTH LN NW
MASSILLON OH
44646-1161
US

IV. Provider business mailing address

3658 WALES AVE NW APT B
MASSILLON OH
44646-1867
US

V. Phone/Fax

Practice location:
  • Phone: 330-704-0879
  • Fax:
Mailing address:
  • Phone: 330-232-5315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: