Provider Demographics
NPI:1932362100
Name:MEYERS, MEREDITH REID (DC)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:REID
Last Name:MEYERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 TALL PINE DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-7701
Mailing Address - Country:US
Mailing Address - Phone:386-308-9393
Mailing Address - Fax:
Practice Address - Street 1:3930 S NOVA RD
Practice Address - Street 2:STE. 103
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9281
Practice Address - Country:US
Practice Address - Phone:386-308-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor