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Individual

TARA MARIE MEYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
3534 BROOKLYN AVE, FORT WAYNE, IN 46809-1361
(260) 478-5230
(260) 478-5235
Mailing address
4251 LAHMEYER RD, FORT WAYNE, IN 46815-5676
(260) 432-4700
(260) 459-9262

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009664A
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100257920
GROUP MEDICAID
IN
01
156546
GROUP MEDICARE
IN
Enumeration date
07/01/2008
Last updated
02/06/2015
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