Individual
MARK JEFFREY MEIVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3151 COUNTY ROAD CH, DODGEVILLE, WI 53533-9108
(608) 513-1518
Mailing address
4601 W BLUE MOUNDS RD, BARNEVELD, WI 53507-9720
(608) 513-1518
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3829-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40170900
—
WI
Enumeration date
04/03/2007
Last updated
07/09/2007
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