Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist |
NPI | 1003136656 |
---|---|
Provider Name | Dr. Jacob Thomas Neece |
First Address | Fairway, KS 66205-3158 |
Second Address | Fairway, KS 66205-3158 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2010 |
Last Update Date | 06/06/2010 |