Provider Demographics
NPI:1073819439
Name:NEAL, KARAN ELIZABETH (PTA)
Entity Type:Individual
Prefix:MRS
First Name:KARAN
Middle Name:ELIZABETH
Last Name:NEAL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-9717
Mailing Address - Country:US
Mailing Address - Phone:304-982-1976
Mailing Address - Fax:
Practice Address - Street 1:522 WOODBRIDGE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-9717
Practice Address - Country:US
Practice Address - Phone:304-982-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV000057225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant