Provider Demographics
NPI:1144762204
Name:GREENE, MEREDITH (DPT)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:GREENE
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 1:1105 W BYPASS
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5255
Mailing Address - Country:US
Mailing Address - Phone:334-222-5785
Mailing Address - Fax:844-757-3731
Practice Address - Street 1:1105 W BYPASS
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5255
Practice Address - Country:US
Practice Address - Phone:334-222-5785
Practice Address - Fax:844-757-3731
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH8242225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist