Provider Demographics
NPI:1225817026
Name:NEESE, SAMUEL DAULTON
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:DAULTON
Last Name:NEESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6091 RACHELS WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-5791
Mailing Address - Country:US
Mailing Address - Phone:606-369-4439
Mailing Address - Fax:
Practice Address - Street 1:6091 RACHELS WAY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-5791
Practice Address - Country:US
Practice Address - Phone:606-369-4439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program