Provider Demographics
NPI:1497181002
Name:NEAL, JOHN C (PTA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:NEAL
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:MR
Other - First Name:CLAI
Other - Middle Name:
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:1419 HAMRIC DR E
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-2173
Mailing Address - Country:US
Mailing Address - Phone:256-241-3242
Mailing Address - Fax:256-241-3252
Practice Address - Street 1:1419 HAMRIC DR E
Practice Address - Street 2:SUITE 201
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-2173
Practice Address - Country:US
Practice Address - Phone:256-241-3242
Practice Address - Fax:256-241-3252
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2-0563174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist