Provider Demographics
NPI:1598700312
Name:NEESON, ANTHONY TODD (MS, ATC, LAT, CSCS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:TODD
Last Name:NEESON
Suffix:
Gender:M
Credentials:MS, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17077 E LITTLE ITALY RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6303
Mailing Address - Country:US
Mailing Address - Phone:985-345-4084
Mailing Address - Fax:
Practice Address - Street 1:17077 E LITTLE ITALY RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-6303
Practice Address - Country:US
Practice Address - Phone:985-345-4084
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9852282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer