MEDICARE: ANNIE MEIER ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer	AT004502	GA

General Provider Information

NPI Number	:	1073203071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNIE MEIER ATC

Provider Business Mailing Address
First Line	:	4023 FIELDCREST DR
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-3531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 EXECUTIVE PARK SOUTH NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-2214
Country	:	US
Telephone Number	:	814-512-8476
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2023
Last Update Date	:	02/09/2025

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Directions to “ ANNIE MEIER ATC” Practice Location

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