Provider Demographics
NPI:1861597478
Name:NEIGHBOR, TODD DAVID (PT)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:DAVID
Last Name:NEIGHBOR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 N 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-2384
Mailing Address - Country:US
Mailing Address - Phone:319-294-6694
Mailing Address - Fax:319-294-6113
Practice Address - Street 1:740 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-2384
Practice Address - Country:US
Practice Address - Phone:319-294-6694
Practice Address - Fax:319-294-6113
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA036682251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1212021Medicare PIN
IAI19172020Medicare PIN
IAIB1213013Medicare PIN
IAI19172Medicare PIN
IAIB1213Medicare PIN
IAIB1212Medicare PIN