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NPI Code Detail

MEDICARE: GINA D. MEYER PHYSICAL THERAPIST

MEDICARE: GINA D. MEYER PHYSICAL THERAPIST
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
1225100000XPhysical Therapist1154270TX
2225100000XPhysical Therapist070015810IL
3225100000XPhysical Therapist2305207230VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CD3789OTHERILMEDICARE RAILRODA GROUP NUMBER
3P00602549OTHERILMEDICARE RAILROAD NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21619908OTHERILBCBS IL GROUP

General Provider Information

NPI Number : 1083638316
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA D. MEYER PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : PO BOX 8561
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23450-8561
Country : US
Telephone Number : 757-748-6003
Fax Number :
Provider Business Practice Location Address
First Line : 1408 N GREAT NECK RD
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-1315
Country : US
Telephone Number : 757-694-7872
Fax Number : 757-340-6210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 02/13/2012

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