Provider Demographics
NPI:1437333457
Name:MEADOWS, LANITA N (PTA)
Entity Type:Individual
Prefix:
First Name:LANITA
Middle Name:N
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5623 BELMONT AVE
Practice Address - Street 2:#111B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-6798
Practice Address - Country:US
Practice Address - Phone:214-826-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2048642225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant