MEDICARE: MS. MICHELE L 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
1	225X00000X	Occupational Therapist	002118	MO

General Provider Information

NPI Number	:	1669529822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELE L MEYER

Provider Business Mailing Address
First Line	:	16551 VICTORIA CROSSING DR
Second Line	:	UNIT F
City	:	GROVER
State	:	MO
Zip	:	63040-1458
Country	:	US
Telephone Number	:	636-405-1532
Fax Number	:

Provider Business Practice Location Address
First Line	:	7370 WELDON SPRINGS RD
Second Line	:
City	:	DARDENNE PRAIRIE
State	:	MO
Zip	:	63368-8702
Country	:	US
Telephone Number	:	636-851-5500
Fax Number	:

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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