Healthcare Provider Details

I. General information

NPI: 1124174065
Provider Name (Legal Business Name): JEFFREY DEAN MEADOWS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 MERRIMON AVE STE 103
ASHEVILLE NC
28804-2366
US

IV. Provider business mailing address

959 MERRIMON AVE STE 103
ASHEVILLE NC
28804-2366
US

V. Phone/Fax

Practice location:
  • Phone: 838-301-4253
  • Fax:
Mailing address:
  • Phone: 828-301-4253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number60510979
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number10794
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10794
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: