Provider Demographics
NPI:1578116539
Name:MCNEIL, KAMI RENEE (PTA)
Entity Type:Individual
Prefix:MISS
First Name:KAMI
Middle Name:RENEE
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 ESTHER CT
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-7633
Mailing Address - Country:US
Mailing Address - Phone:209-579-4774
Mailing Address - Fax:
Practice Address - Street 1:146 N MAAG AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-2249
Practice Address - Country:US
Practice Address - Phone:209-322-2140
Practice Address - Fax:209-322-2142
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant