Individual
CASEY MICHAEL MCNEILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2054 PARK ST, JACKSONVILLE, FL 32204-3810
(352) 895-4854
Mailing address
2054 PARK ST, JACKSONVILLE, FL 32204-3810
(352) 895-4854
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23708
FL
Other
Enumeration date
05/13/2018
Last updated
05/13/2018
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