Healthcare Provider Details

I. General information

NPI: 1851227391
Provider Name (Legal Business Name): TRAVIS MECKLEY OT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 7TH ST
FREDERICK MD
21701-4506
US

IV. Provider business mailing address

8910 PURDUE RD STE 700
INDIANAPOLIS IN
46268-6136
US

V. Phone/Fax

Practice location:
  • Phone: 800-603-6046
  • Fax:
Mailing address:
  • Phone: 800-603-6046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10371
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: