Provider Demographics
NPI:1639398936
Name:BRENDA NEER PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:BRENDA NEER PHYSICAL THERAPY INC
Other - Org Name:CHOWCHILLA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:559-665-1709
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-0185
Mailing Address - Country:US
Mailing Address - Phone:559-665-1709
Mailing Address - Fax:559-665-1767
Practice Address - Street 1:285 HOSPITAL DR
Practice Address - Street 2:ROOM 29
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2041
Practice Address - Country:US
Practice Address - Phone:559-665-1709
Practice Address - Fax:559-665-1767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7911225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ07356ZOtherBLUE SHIELD GROUP #
CA=========OtherTIN
CA00PT79111Medicare ID - Type Unspecified
CAP00236727Medicare ID - Type Unspecified
CAZZZ07356ZOtherBLUE SHIELD GROUP #
CAZZZ26320ZMedicare ID - Type Unspecified
CADD5757Medicare ID - Type Unspecified