MEDICARE: DR. MICHELLE ANN MCNEAL PT, PHD

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	2251P0200X	Pediatric Physical Therapist	PT00009922	WA

General Provider Information

NPI Number	:	1659597433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE ANN MCNEAL PT, PHD

Provider Business Mailing Address
First Line	:	233 S FOREST ST
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-5811
Country	:	US
Telephone Number	:	360-671-2060
Fax Number	:	360-671-2060

Provider Business Practice Location Address
First Line	:	233 S FOREST ST
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-5811
Country	:	US
Telephone Number	:	360-671-2060
Fax Number	:	360-671-2060

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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