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Individual

MOLLY MCNEIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LAT, ATC

Contact information

Practice address
2775 SCHOENERSVILLE RD, BETHLEHEM, PA 18017-7307
(877) 247-8080
Mailing address
132 WARREN LN, BRODHEADSVILLE, PA 18322-7128
(610) 507-5035

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004973
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000004029
BOC CERTIFICATION NUMBER
PA
01
RT004973
PA STATE LICENSE NUMBER
PA
Enumeration date
12/28/2015
Last updated
12/28/2015
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