Provider Demographics
NPI:1558588608
Name:MCNEIL, ROBERT L (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:MCNEIL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1838 VANCROFT CT
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3627
Mailing Address - Country:US
Mailing Address - Phone:770-394-4274
Mailing Address - Fax:770-394-2137
Practice Address - Street 1:5462 MEMORIAL DR
Practice Address - Street 2:SUITE 203
Practice Address - City:STONE MTN
Practice Address - State:GA
Practice Address - Zip Code:30083-3239
Practice Address - Country:US
Practice Address - Phone:404-297-9330
Practice Address - Fax:404-297-9329
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist