Provider Demographics
NPI:1972672988
Name:O'NEIL, CRAIG (PT,OCS,MTC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:PT,OCS,MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 SUMMERSET GRN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7168
Mailing Address - Country:US
Mailing Address - Phone:615-662-9018
Mailing Address - Fax:
Practice Address - Street 1:2001 MALLORY LN
Practice Address - Street 2:SUITE 201
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8233
Practice Address - Country:US
Practice Address - Phone:615-373-1350
Practice Address - Fax:615-221-9054
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4134988OtherBLUE CROSS BLUE SHIELD