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NPI Code Detail

MEDICARE: THERESA ANNE MEYERS PTA

MEDICARE:   THERESA ANNE MEYERS  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical TherapistPTA 23709FL

General Provider Information

NPI Number : 1619215761
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA ANNE MEYERS PTA
Provider Business Mailing Address
First Line : 11366 EMILY'S CROSSING COURT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257
Country : US
Telephone Number : 904-608-5602
Fax Number : 904-292-2807
Provider Business Practice Location Address
First Line : 11366 EMILYS CROSSING CT
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-1530
Country : US
Telephone Number : 904-608-5602
Fax Number : 904-292-2807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2013
Last Update Date : 01/24/2013

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Directions to “ THERESA ANNE MEYERS PTA” Practice Location

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