Provider Demographics
NPI:1356336465
Name:NEVILLE, ROBERT BRIAN (OTR/L, CHT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BRIAN
Last Name:NEVILLE
Suffix:
Gender:M
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N EAGLE CREEK DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1889
Mailing Address - Country:US
Mailing Address - Phone:859-264-8866
Mailing Address - Fax:859-264-1167
Practice Address - Street 1:151 N EAGLE CREEK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1889
Practice Address - Country:US
Practice Address - Phone:859-264-8866
Practice Address - Fax:859-264-1167
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2216225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
0718406Medicare PIN