Provider Demographics
NPI:1457039802
Name:MEYER, MONICA (DPT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MEYER
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 1:2812 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6202
Mailing Address - Country:US
Mailing Address - Phone:620-208-7878
Mailing Address - Fax:620-208-7000
Practice Address - Street 1:2812 W 12TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6202
Practice Address - Country:US
Practice Address - Phone:620-208-7878
Practice Address - Fax:620-208-7000
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11-07463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty