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NPI Code Detail

MEDICARE: THERESA LYNN MEYER

MEDICARE: THERESA LYNN MEYER
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 TherapistPT01170MO

General Provider Information

NPI Number : 1437713237
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA LYNN MEYER
Provider Business Mailing Address
First Line : 1624 MADISON 310
Second Line :
City : MARQUAND
State : MO
Zip : 63655-8705
Country : US
Telephone Number : 636-358-6913
Fax Number :
Provider Business Practice Location Address
First Line : 2333 CHAPEL HILL RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-1568
Country : US
Telephone Number : 573-234-1091
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2019
Last Update Date : 04/26/2019

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