Provider Demographics
NPI:1336989276
Name:MCNEILL, ALYSSA (ATC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4916 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2684
Mailing Address - Country:US
Mailing Address - Phone:252-269-5183
Mailing Address - Fax:
Practice Address - Street 1:4916 HOLLY LN
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2684
Practice Address - Country:US
Practice Address - Phone:252-269-5183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer