Provider Demographics
NPI:1598065252
Name:MEYER, JOANNA RL (PT)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:RL
Last Name:MEYER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 MILL ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NY
Mailing Address - Zip Code:14505-9602
Mailing Address - Country:US
Mailing Address - Phone:315-521-7262
Mailing Address - Fax:
Practice Address - Street 1:3660 MILL ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NY
Practice Address - Zip Code:14505-9602
Practice Address - Country:US
Practice Address - Phone:315-521-7262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist