MEDICARE: NEIL MICHAEL DAAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	3851	NM

General Provider Information

NPI Number	:	1457846842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEIL MICHAEL DAAN

Provider Business Mailing Address
First Line	:	2502 VELARDE PL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1591 E LOHMAN AVE
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-3185
Country	:	US
Telephone Number	:	575-644-6306
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	06/27/2018

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