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General NPI Number Information
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NPI Number | 1265504450
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Entity Type | Individual
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Provider Name | JENNIFER SKULY MEADOWS DPT
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 2020 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209-4604
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Country | US
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Telephone | 941-782-6180
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Fax |
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Provider Business Mailing Address
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Address Line | 14818 7TH AVE E
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City | BRADENTON
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State | FL
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Zip | 34212-2902
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Country | US
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Telephone | 941-993-6735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT19862
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 9323
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | PT19862
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License Number State | FL
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