Individual
MRS. NIKOLE EMBER MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
220 DUNES PLZ, MICHIGAN CITY, IN 46360-7340
(219) 874-3750
Mailing address
4091 W ERIN DR, LA PORTE, IN 46350-7456
(219) 324-0390
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31003145A
IN
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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