Provider Demographics
NPI:1508527672
Name:MAYER, ELIZABETH PATE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PATE
Last Name:MAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:DANIELLE
Other - Last Name:PATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 52592
Mailing Address - Street 2:
Mailing Address - City:FORT MOORE
Mailing Address - State:GA
Mailing Address - Zip Code:31995-2592
Mailing Address - Country:US
Mailing Address - Phone:205-602-8114
Mailing Address - Fax:
Practice Address - Street 1:2700 CORPORATE DR STE 225
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-2721
Practice Address - Country:US
Practice Address - Phone:205-970-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer