Individual
WADE AUSTEN MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4031 N DIXIE HWY STE 104, ELIZABETHTOWN, KY 42701-7874
(270) 982-4776
(270) 982-4778
Mailing address
383 CORBIN CENTER DR, CORBIN, KY 40701-1895
(606) 526-2911
(606) 526-2901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008700
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008700
STATE LICENSE
KY
Enumeration date
11/03/2022
Last updated
11/03/2022
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