Provider Demographics
NPI:1609052323
Name:JASON E MEYER PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:JASON E MEYER PHYSICAL THERAPY PC
Other - Org Name:DUBUQUE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:563-582-4170
Mailing Address - Street 1:1705 DELHI STREET, LOWER LEVEL
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-5901
Mailing Address - Country:US
Mailing Address - Phone:563-582-4170
Mailing Address - Fax:563-582-4181
Practice Address - Street 1:2300 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002
Practice Address - Country:US
Practice Address - Phone:563-588-3891
Practice Address - Fax:563-588-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02877261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy