Provider Demographics
NPI:1265982086
Name:MEAUX, CHRISTINE NICOLE (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:NICOLE
Last Name:MEAUX
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:LA
Mailing Address - Zip Code:70575-0085
Mailing Address - Country:US
Mailing Address - Phone:337-591-3481
Mailing Address - Fax:
Practice Address - Street 1:5501 OLD HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4881
Practice Address - Country:US
Practice Address - Phone:423-847-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09462225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist