Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 0439 | SD |
N | 2251X0800X | Physical Therapist - Orthopedic | 0439 | SD |
NPI | 1003105016 |
---|---|
Provider Name | William C Meredith |
First Address | Sioux Falls, SD 57106-2322 |
Second Address | Sioux Falls, SD 57106-2322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2011 |
Last Update Date | 30/03/2011 |