Healthcare Provider Details
I. General information
NPI: 1033879812
Provider Name (Legal Business Name): ALLISON MEYER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/21/2021
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
375 ROLLING OAKS DR STE 210
THOUSAND OAKS CA
91361-1028
US
IV. Provider business mailing address
5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US
V. Phone/Fax
- Phone: 805-497-7015
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 301481 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: