Individual
AIYANA B. MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2600 NEWBURG RD, FORTUNA, CA 95540-2536
(707) 725-6995
Mailing address
2306 DEAN ST, EUREKA, CA 95501-3209
(707) 443-8354
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 34300
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH2219
RR MEDICARE #
CA
Enumeration date
12/18/2007
Last updated
05/17/2013
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