Provider Demographics
NPI:1669439121
Name:METEER, JAMIE MARIE (PTA)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:MARIE
Last Name:METEER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:MARIE
Other - Last Name:MOWBRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:300 MARGARET AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6014
Mailing Address - Country:US
Mailing Address - Phone:410-848-8364
Mailing Address - Fax:
Practice Address - Street 1:6190 GEORGETOWN BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6460
Practice Address - Country:US
Practice Address - Phone:410-552-4235
Practice Address - Fax:410-552-4248
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3002225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD216566Medicare ID - Type Unspecified