Provider Demographics
NPI:1821487349
Name:NEUENFELDT, ERIC (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:NEUENFELDT
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 HARBOUR TOWNE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1443
Mailing Address - Country:US
Mailing Address - Phone:989-964-8329
Mailing Address - Fax:
Practice Address - Street 1:2980 S DEHMEL RD
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-9740
Practice Address - Country:US
Practice Address - Phone:989-964-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0074622255A2300X
MI26010017302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer