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NPI Code Detail

MEDICARE: ALEX NEAL PTA

MEDICARE:   ALEX  NEAL  PTA
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
1225200000XPhysical Therapy Assistant2718-19WI

General Provider Information

NPI Number : 1992205272
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX NEAL PTA
Provider Business Mailing Address
First Line : 434 COUNTY ROAD MM
Second Line :
City : BROOKLYN
State : WI
Zip : 53521-9466
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1100 E VERONA AVE
Second Line :
City : VERONA
State : WI
Zip : 53593-8717
Country : US
Telephone Number : 608-845-1261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2018
Last Update Date : 02/13/2018

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Directions to “ ALEX NEAL PTA” Practice Location

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