Board-certified Orthopedic Clinical Specialist Neils Methlagl holds California physical therapy license 39822, NPI 1831534502, and a Certified McKenzie Therapist credential from the McKenzie Institute, running a manual-therapy caseload at 4060 Fourth Ave Suite 206 in 92103. Mechanical Diagnosis and Therapy drives evaluation here — patients with cervical or lumbar derangements work through directional preference testing, then take home self-treatment protocols built to reduce surgical referrals, an approach that pairs naturally with the postural-realignment training at Function First on University Avenue. Clinical practice spans large neuro-rehabilitation centers in Austria and high-volume outpatient orthopedic clinics in San Diego, building a diagnostic eye for distinguishing nerve root compression from referred myofascial pain. When McKenzie progression reveals a structural lesion that won't centralize, the practice routes patients toward orthopedic consults with surgeons such as Dr. Robert S. Meyer, MD at the UC San Diego campus. The most complex files include post-laminectomy syndrome and chronic radiculopathy where directional-preference rehab is layered with neural mobilization and progressive loading on previously failed surgical patients.