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Individual

NEIL DE CLEENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT, ATC

Contact information

Practice address
1107 HART BLVD, MONTICELLO, MN 55362-8538
(920) 309-1930
Mailing address
3461 KENT ST APT 1110, SHOREVIEW, MN 55126-4022
(920) 309-1930

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12014
MN
2255A2300X
Athletic Trainer
3358
MN
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
05/11/2017
Last updated
09/15/2020
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