Provider Demographics
NPI:1215401633
Name:MEYERS, DARLENE (LMT)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:MEYERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2161
Mailing Address - Street 2:
Mailing Address - City:BRANSON WEST
Mailing Address - State:MO
Mailing Address - Zip Code:65737-2161
Mailing Address - Country:US
Mailing Address - Phone:417-272-1464
Mailing Address - Fax:
Practice Address - Street 1:11016 E STATE HIGHWAY 76 STE 21
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-9775
Practice Address - Country:US
Practice Address - Phone:417-272-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001013912225700000X
MO2017025446225700000X
MO2013034802225700000X
MO2002009212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist