Provider Demographics
NPI:1922580380
Name:MEISTER, ALI RENEE (LMT)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:RENEE
Last Name:MEISTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 N ELM STREET
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801
Mailing Address - Country:US
Mailing Address - Phone:720-633-4138
Mailing Address - Fax:
Practice Address - Street 1:114 W 3RD STREET
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801
Practice Address - Country:US
Practice Address - Phone:720-633-4138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3592225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty