Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant |
NPI | 1003946740 |
---|---|
Provider Name | Marylou F Neal |
First Address | Easton, PA 18040-7958 |
Second Address | Effort, PA 18330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 09/07/2007 |