Provider Demographics
NPI:1720559263
Name:MEEKER, AMY (AP, DOM)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:MEEKER
Suffix:
Gender:F
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6158 CANDLEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-5304
Mailing Address - Country:US
Mailing Address - Phone:845-656-7279
Mailing Address - Fax:
Practice Address - Street 1:6158 CANDLEWOOD WAY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-5304
Practice Address - Country:US
Practice Address - Phone:845-656-7279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4005171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist