Healthcare Provider Details

I. General information

NPI: 1831318211
Provider Name (Legal Business Name): MEREDITH BLEILER WRIGHT PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SUN AVE NE
ALBUQUERQUE NM
87109-4373
US

IV. Provider business mailing address

1418 GALLBERRY CT
TRINITY FL
34655-4918
US

V. Phone/Fax

Practice location:
  • Phone: 727-573-2747
  • Fax:
Mailing address:
  • Phone: 727-808-2619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA 20549
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: