Individual
MR. MICHAEL CALVIN NEILL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367-1366
(636) 625-5200
Mailing address
19728 TOWNSHIP LINE RD, WARRENTON, MO 63383-4448
(636) 279-4658
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
155183
MO
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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