Healthcare Provider Details

I. General information

NPI: 1851395545
Provider Name (Legal Business Name): ROGER J MEADE PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

IV. Provider business mailing address

7 VANDERBILT PARK DR
ASHEVILLE NC
28803-1700
US

V. Phone/Fax

Practice location:
  • Phone: 828-255-7776
  • Fax: 828-274-7855
Mailing address:
  • Phone: 828-255-7776
  • Fax: 828-274-7855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1187
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: