Provider Demographics
NPI:1376217513
Name:NEFF, JUSTICE LYNN (PTA)
Entity Type:Individual
Prefix:MS
First Name:JUSTICE
Middle Name:LYNN
Last Name:NEFF
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 1:1105 SE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-1136
Mailing Address - Country:US
Mailing Address - Phone:319-572-7341
Mailing Address - Fax:
Practice Address - Street 1:1105 SE 5TH ST
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-1136
Practice Address - Country:US
Practice Address - Phone:319-572-7341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA090132225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant