Provider Demographics
NPI:1255639746
Name:LANGRIDGE, NEIL M
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:M
Last Name:LANGRIDGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 FOOTHILLS BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6527
Mailing Address - Country:US
Mailing Address - Phone:916-797-2273
Mailing Address - Fax:916-797-8599
Practice Address - Street 1:5131 FOOTHILLS BLVD STE 5
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-6527
Practice Address - Country:US
Practice Address - Phone:916-797-2273
Practice Address - Fax:916-797-8599
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT4638225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant