Healthcare Provider Details

I. General information

NPI: 1619480829
Provider Name (Legal Business Name): MEREDITH HARRIS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 20TH ST NW STE 116
WASHINGTON DC
20036
US

IV. Provider business mailing address

2901 CONNECTICUT AVE NW APT 207
WASHINGTON DC
20008-1454
US

V. Phone/Fax

Practice location:
  • Phone: 202-416-2110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT872456
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: