Healthcare Provider Details

I. General information

NPI: 1700470887
Provider Name (Legal Business Name): VALERIE ANDERSON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE MESKILL

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 07/23/2025
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3656 MALL DRIVE
EAU CLAIRE WI
54701
US

IV. Provider business mailing address

3656 MALL DRIVE
EAU CLAIRE WI
54701
US

V. Phone/Fax

Practice location:
  • Phone: 715-229-2172
  • Fax:
Mailing address:
  • Phone: 715-229-2172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3117-19
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number3117-19
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: