Provider Demographics
NPI:1255524294
Name:MEADOWS, VALERIE SUE (CPTA)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:SUE
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:SUE
Other - Last Name:HARBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPTA
Mailing Address - Street 1:749 W A AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:KS
Mailing Address - Zip Code:67068-1210
Mailing Address - Country:US
Mailing Address - Phone:620-960-6264
Mailing Address - Fax:
Practice Address - Street 1:749 W A AVE
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:KS
Practice Address - Zip Code:67068-1210
Practice Address - Country:US
Practice Address - Phone:620-960-6264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00952225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant