Provider Demographics
NPI:1639376460
Name:MEJEUR, JOANNE KAY (PTA)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:KAY
Last Name:MEJEUR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:JOANNE
Other - Middle Name:KAY
Other - Last Name:LEEP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1675 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:MI
Mailing Address - Zip Code:49070-9785
Mailing Address - Country:US
Mailing Address - Phone:269-672-7350
Mailing Address - Fax:
Practice Address - Street 1:3491 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MI
Practice Address - Zip Code:49419-9512
Practice Address - Country:US
Practice Address - Phone:269-751-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant