Provider Demographics
NPI:1861693939
Name:NEAL, CECIL E (PT)
Entity type:Individual
Prefix:
First Name:CECIL
Middle Name:E
Last Name:NEAL
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 1:2222 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4872
Mailing Address - Country:US
Mailing Address - Phone:602-277-6211
Mailing Address - Fax:866-242-5309
Practice Address - Street 1:6320 W UNION HILLS DR
Practice Address - Street 2:SUITE B1800
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1096
Practice Address - Country:US
Practice Address - Phone:602-277-6211
Practice Address - Fax:866-242-5309
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10292251X0800X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ782012Medicaid
AZ1029OtherLICENSE #
AZZ78417Medicare PIN
AZ1029OtherLICENSE #