Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT023267 | PA |
NPI | 1003236308 |
---|---|
Provider Name | Dr. Thomas Calvin Mealing |
First Address | Islandia, NY 11749-5258 |
Second Address | Lake Wylie, SC 29710-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 10/04/2018 |