Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT014315 | GA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT014315 | GA |
NPI | 1073150736 |
---|---|
Provider Name | Elisabeth Jean Meany |
First Address | Richmond Hill, GA 31324-5491 |
Second Address | Savannah, GA 31406-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2019 |
Last Update Date | 02/12/2019 |