Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | J1-0003568 | DE |
N | 2251S0007X | Physical Therapist - Sports | 25845 | MD |
NPI | 1538556493 |
---|---|
Provider Name | Sarah Neal |
First Address | Bolingbrook, IL 60440-4909 |
Second Address | Wilmington, DE 19810-4581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2015 |
Last Update Date | 19/09/2016 |