Provider Demographics
NPI:1235343260
Name:JOHNSON-NEAL, CHRISTY L (LMT)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:JOHNSON-NEAL
Suffix:
Gender:F
Credentials:LMT
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 7
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-0007
Mailing Address - Country:US
Mailing Address - Phone:515-745-2488
Mailing Address - Fax:
Practice Address - Street 1:5525 MERLE HAY RD
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1444
Practice Address - Country:US
Practice Address - Phone:515-745-2488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04301225700000X
WAMA00017195225700000X
OR11465225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist