Individual
DAVID C NEELY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 NE BROADWAY ST, SUBLIMITY, OR 97385-9505
(971) 218-0871
Mailing address
120 NE BROADWAY ST, SUBLIMITY, OR 97385-9505
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DZ742290
—
OR
Enumeration date
03/02/2022
Last updated
03/02/2022
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