Provider Demographics
NPI:1497881809
Name:O'NEEL, ROBERT M
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:O'NEEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10916 GREENBRIER RD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-3474
Mailing Address - Country:US
Mailing Address - Phone:952-541-1799
Mailing Address - Fax:
Practice Address - Street 1:1411 W SAINT GERMAIN ST
Practice Address - Street 2:#203
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4121
Practice Address - Country:US
Practice Address - Phone:320-654-0505
Practice Address - Fax:320-654-8421
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2646237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist