Provider Demographics
NPI:1457734907
Name:MEEKS, SHANETTE (RRT)
Entity Type:Individual
Prefix:
First Name:SHANETTE
Middle Name:
Last Name:MEEKS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 E MAIN ST
Mailing Address - Street 2:APT. 1437
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-4238
Mailing Address - Country:US
Mailing Address - Phone:803-378-0089
Mailing Address - Fax:
Practice Address - Street 1:959 E MAIN ST
Practice Address - Street 2:APT. 1437
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-4238
Practice Address - Country:US
Practice Address - Phone:803-378-0089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4373227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered