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Individual

JAY WALTER NEAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1875 CANDLELIGHT CT, OWINGS, MD 20736-3616
(443) 756-3029
Mailing address
1875 CANDLELIGHT CT, OWINGS, MD 20736-3616
(443) 756-3029

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17825
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432131600
MD
01
533439-05
BCBS INDIVIDUAL
MD
Enumeration date
07/26/2006
Last updated
08/29/2019
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