Provider Demographics
NPI:1124543533
Name:MCNEELY, SOPHIE ALEXANDRA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:ALEXANDRA
Last Name:MCNEELY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5843 OAKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-7624
Mailing Address - Country:US
Mailing Address - Phone:303-883-1053
Mailing Address - Fax:
Practice Address - Street 1:501 S CHERRY ST FL 11
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1325
Practice Address - Country:US
Practice Address - Phone:720-821-6207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist