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General NPI Number Information
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NPI Number | 1659683076
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Entity Type | Individual
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Provider Name | AMY MARIE MCNEAL A.A.S.L.M.T
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Gender | Female
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 28811 S. TAMIAMI TRAIL UNIT 13-14
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City | BONITA SPRINGS
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State | FL
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Zip | 34134
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Country | US
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Telephone | 239-948-5555
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Fax | 239-948-3325
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Provider Business Mailing Address
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Address Line | PO BOX 1916
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City | BONITA SPRINGS
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State | FL
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Zip | 34133
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Country | US
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Telephone | 615-556-2812
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Fax | 239-498-1256
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA56347
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License Number State | FL
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