Individual
JULIE A MEEHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
729 PARK ST, ANTIGO, WI 54409-2745
(715) 362-5583
Mailing address
729 PARK ST, ANTIGO, WI 54409-2745
(715) 362-5583
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1292-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40480500
—
WI
Enumeration date
04/17/2008
Last updated
04/17/2008
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