Provider Demographics
NPI:1750484101
Name:NEASE, MICHAEL CHRISTOPHER (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CHRISTOPHER
Last Name:NEASE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17815 COUNTRYSIDE CT
Mailing Address - Street 2:
Mailing Address - City:PRUNEDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93907-8804
Mailing Address - Country:US
Mailing Address - Phone:831-444-5989
Mailing Address - Fax:831-663-9422
Practice Address - Street 1:17815 COUNTRYSIDE CT
Practice Address - Street 2:
Practice Address - City:PRUNEDALE
Practice Address - State:CA
Practice Address - Zip Code:93907-8804
Practice Address - Country:US
Practice Address - Phone:831-444-5989
Practice Address - Fax:831-663-9422
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29321225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist