Provider Demographics
NPI:1922061233
Name:MEISER, TODD EDWARD (LPT)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:EDWARD
Last Name:MEISER
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 W BETHALTO DR
Mailing Address - Street 2:
Mailing Address - City:BETHALTO
Mailing Address - State:IL
Mailing Address - Zip Code:62010-1889
Mailing Address - Country:US
Mailing Address - Phone:618-972-2587
Mailing Address - Fax:618-377-9928
Practice Address - Street 1:416 W BETHALTO DR
Practice Address - Street 2:
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010-1889
Practice Address - Country:US
Practice Address - Phone:618-972-2587
Practice Address - Fax:618-377-9928
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
342305OtherHEALTHLINK
IL6823160OtherBCBS
IL6823160OtherBCBS