Provider Demographics
NPI:1871961987
Name:NEICE, WILLIAM (PTA)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:NEICE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CALHOUN RD
Mailing Address - Street 2:
Mailing Address - City:OLIVE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:41164-5933
Mailing Address - Country:US
Mailing Address - Phone:606-738-4636
Mailing Address - Fax:
Practice Address - Street 1:125 CALHOUN RD
Practice Address - Street 2:
Practice Address - City:OLIVE HILL
Practice Address - State:KY
Practice Address - Zip Code:41164-5933
Practice Address - Country:US
Practice Address - Phone:606-738-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA03062225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant