Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 9401460 | NC |
NPI | 1205216173 |
---|---|
Provider Name | Henry Neale SR. |
First Address | Montreat, NC 28757 |
Second Address | Montreat, NC 28757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2015 |
Last Update Date | 04/06/2015 |