Doctor Name: | MRS. STACEY A. NEVILLE |
NPI Number: | 1578520276 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 6566 |
Business Practice Address: | 4415 West 36 1/2 Street St. Louis Park, MN - 55416 |
Business Phone Number: | 9529279717 |
Business Fax Number: | 9529277687 |
Mailing Address: | 4415 West 36 1/2 Street, ST. LOUIS PARK |
State: | MN |
Postal Code: | 55416 |
Phone Number: | 9529279717 |
Fax Number: | 9529277687 |
NPI Enumeration Date: | 04/27/2006 |
NPI Last Update Date: | 11/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |