Provider Demographics
NPI:1619142643
Name:MCNEILL, JAIME ANNETTE (LMT)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:ANNETTE
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:UNIVERSITY CLUB TOWERS 1722 S CARSON AVE
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119
Mailing Address - Country:US
Mailing Address - Phone:918-587-7111
Mailing Address - Fax:918-587-1177
Practice Address - Street 1:1722 S CARSON AVE
Practice Address - Street 2:SUITE 3100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119
Practice Address - Country:US
Practice Address - Phone:918-587-7111
Practice Address - Fax:918-587-1177
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKM5025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist