Individual
GLEN EDWARD NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1087 13TH ST SE, CHILDREN'S NEUROTHERAPY SERVICES, HICKORY, NC 28602-4165
(828) 267-1688
(828) 267-1690
Mailing address
1087 13TH ST SE, CHILDREN'S NEUROTHERAPY SERVICES, HICKORY, NC 28602-4165
(828) 267-1688
(828) 267-1690
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
8374
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11314691
CAQH
—
01
—
1274J
BCBS
NC
05
—
7210860
—
NC
01
—
9157627
PHCS
—
01
—
A3902
MEDCOST
NC
Enumeration date
02/03/2006
Last updated
02/12/2008
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