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General NPI Number Information
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NPI Number | 1295323871
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Entity Type | Individual
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Provider Name | MEKAYLA ROSE MEEKER PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 710 E MAIN ST
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City | HART
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State | MI
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Zip | 49420-1175
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Country | US
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Telephone | 231-873-6026
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Fax |
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Provider Business Mailing Address
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Address Line | 3202 W BUCHANAN RD
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City | SHELBY
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State | MI
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Zip | 49455-9228
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Country | US
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Telephone | 231-233-1049
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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 | 5501019883
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License Number State | MI
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