Provider Demographics
NPI:1477848885
Name:GAUTHIER, MEREDITH DAWN (ATC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:DAWN
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 BRYCE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7956
Mailing Address - Country:US
Mailing Address - Phone:615-512-0808
Mailing Address - Fax:
Practice Address - Street 1:4020 BRYCE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-7956
Practice Address - Country:US
Practice Address - Phone:615-269-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer