Provider Demographics
NPI:1396198883
Name:NEAL, CHRIS
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:NEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:LEE
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:119 GLENN BRYANT RD
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-5305
Mailing Address - Country:US
Mailing Address - Phone:912-271-1441
Mailing Address - Fax:
Practice Address - Street 1:119 GLENN BRYANT RD
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-5305
Practice Address - Country:US
Practice Address - Phone:912-271-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA003488225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant