=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467050450
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID KIRK MEIER JR. DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2020
-----------------------------------------------------
Last Update Date | 10/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 166 ATHLETIC DR
-----------------------------------------------------
City | SHELBURNE
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05482-4433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-985-4440
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260 S UNION ST APT 1B
-----------------------------------------------------
City | BURLINGTON
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05401-4593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 040.0134091
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------