Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | 42368 | CA |
NPI | 1043344724 |
---|---|
Provider Name | Cheri Ann Meadowlark |
First Address | Johnson City, TN 37615-6205 |
Second Address | Big Stone Gap, VA 24219-1105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 10/05/2021 |