Provider Demographics
NPI:1316347768
Name:O'NEIL, JOHN L (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:O'NEIL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 WASHINGTON RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5750
Mailing Address - Country:US
Mailing Address - Phone:443-605-0505
Mailing Address - Fax:443-605-0506
Practice Address - Street 1:826 WASHINGTON RD
Practice Address - Street 2:SUITE 211
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5750
Practice Address - Country:US
Practice Address - Phone:443-605-0505
Practice Address - Fax:443-605-0506
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25148225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist