MEDICARE: MR. MICHAEL CHRISTOPHER NEASE P.T.

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	225100000X	Physical Therapist	PT29321	CA

General Provider Information

NPI Number	:	1750484101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL CHRISTOPHER NEASE P.T.

Provider Business Mailing Address
First Line	:	17815 COUNTRYSIDE CT
Second Line	:
City	:	PRUNEDALE
State	:	CA
Zip	:	93907-8804
Country	:	US
Telephone Number	:	831-444-5989
Fax Number	:	831-663-9422

Provider Business Practice Location Address
First Line	:	17815 COUNTRYSIDE CT
Second Line	:
City	:	PRUNEDALE
State	:	CA
Zip	:	93907-8804
Country	:	US
Telephone Number	:	831-444-5989
Fax Number	:	831-663-9422

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

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	08/10/2022

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