Provider Demographics
NPI:1013948108
Name:NEIL, FRED (DC)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:
Last Name:NEIL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 MERIDIAN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5559
Mailing Address - Country:US
Mailing Address - Phone:360-676-8227
Mailing Address - Fax:360-676-8847
Practice Address - Street 1:4151 MERIDIAN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5559
Practice Address - Country:US
Practice Address - Phone:360-676-8227
Practice Address - Fax:360-676-8847
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1713111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor