Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 52010001761 | MI |
NPI | 1144872979 |
---|---|
Provider Name | Jill Renae Meints |
First Address | Augusta, MI 49012-9723 |
Second Address | Battle Creek, MI 49015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2019 |
Last Update Date | 11/07/2019 |