Individual
CHAD MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
500 GRANT AVE., OMRO, WI 54963
(920) 810-2825
Mailing address
500 GRANT AVE, OMRO, WI 54963-1342
(920) 810-2825
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
474527
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871801621
—
WI
Enumeration date
09/15/2010
Last updated
11/13/2012
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