Provider Demographics
NPI:1417399775
Name:NEVES, WHITNEY JAY (DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:JAY
Last Name:NEVES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S. 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BASIN
Mailing Address - State:WY
Mailing Address - Zip Code:82410
Mailing Address - Country:US
Mailing Address - Phone:307-568-9399
Mailing Address - Fax:307-568-9396
Practice Address - Street 1:406 S. 4TH ST
Practice Address - Street 2:
Practice Address - City:BASIN
Practice Address - State:WY
Practice Address - Zip Code:82410
Practice Address - Country:US
Practice Address - Phone:307-568-9399
Practice Address - Fax:307-568-9396
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist