Provider Demographics
NPI:1629300348
Name:NEAL, MICHELE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:ANN
Last Name:NEAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S 500 E
Mailing Address - Street 2:#202
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1023
Mailing Address - Country:US
Mailing Address - Phone:801-582-2011
Mailing Address - Fax:801-532-4710
Practice Address - Street 1:34 S 500 E
Practice Address - Street 2:#202
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1023
Practice Address - Country:US
Practice Address - Phone:801-582-2011
Practice Address - Fax:801-532-4710
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2019111N00000X
UT8255186-1202111N00000X
UT8255186-1201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist