Provider Demographics
NPI:1053833871
Name:MEYERS, CASSANDRA ANN (DPT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANN
Last Name:MEYERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-8167
Mailing Address - Country:US
Mailing Address - Phone:513-203-8400
Mailing Address - Fax:
Practice Address - Street 1:11045 BROADWAY STE F
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7474
Practice Address - Country:US
Practice Address - Phone:513-203-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012456A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics