Provider Demographics
NPI:1053891366
Name:NEUBAUER, MACKENZIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:
Other - Last Name:MCELHANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3077 INVESTORS RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9229
Mailing Address - Country:US
Mailing Address - Phone:724-825-9337
Mailing Address - Fax:
Practice Address - Street 1:500 ST LUKES DR
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-5000
Practice Address - Country:US
Practice Address - Phone:866-785-8537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist