Healthcare Provider Details

I. General information

NPI: 1851733968
Provider Name (Legal Business Name): PAMELA ANN MEEK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 07/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 E MACK AVE
OLNEY IL
62450-2319
US

IV. Provider business mailing address

15267 BILLET LN
SAINT FRANCISVILLE IL
62460-3167
US

V. Phone/Fax

Practice location:
  • Phone: 618-395-7421
  • Fax:
Mailing address:
  • Phone: 618-943-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number056.003057
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: