Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT-796 | WY |
N | 2251N0400X | Physical Therapist - Neurology | PT-796 | WY |
N | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1366772170 |
---|---|
Provider Name | Marian L Meyers |
First Address | Jackson, WY 83001-9350 |
Second Address | Jackson, WY 83001-9350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2009 |
Last Update Date | 30/12/2009 |