Provider Demographics
NPI:1689383200
Name:NEU, ALLIE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:NEU
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:
Other - Last Name:HEMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:15851 41ST ST
Mailing Address - Street 2:
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-8523
Mailing Address - Country:US
Mailing Address - Phone:320-290-7121
Mailing Address - Fax:
Practice Address - Street 1:901 3RD ST N
Practice Address - Street 2:
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1964
Practice Address - Country:US
Practice Address - Phone:320-217-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer