Provider Demographics
NPI:1083824635
Name:MCNEILL, WINSLOW JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:WINSLOW
Middle Name:JAMES
Last Name:MCNEILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221
Mailing Address - Street 2:
Mailing Address - City:EAGAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85925-0221
Mailing Address - Country:US
Mailing Address - Phone:928-245-1153
Mailing Address - Fax:
Practice Address - Street 1:74 N MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:EAGAR
Practice Address - State:AZ
Practice Address - Zip Code:85925-9713
Practice Address - Country:US
Practice Address - Phone:928-333-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor