Provider Demographics
NPI:1245688225
Name:NEAL, CHAD (DPT)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:NEAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 N SAGINAW RD STE C
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2690
Mailing Address - Country:US
Mailing Address - Phone:989-837-1529
Mailing Address - Fax:989-837-2499
Practice Address - Street 1:2600 N SAGINAW RD STE C
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2690
Practice Address - Country:US
Practice Address - Phone:989-837-1529
Practice Address - Fax:989-837-2499
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017716225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist