Individual
JEFFERY GERARD MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
122 PALOMINO LN, LINO LAKES, MN 55014-2913
(651) 784-0862
Mailing address
122 PALOMINO LN, LINO LAKES, MN 55014-2913
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5030
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
634554900
—
MN
Enumeration date
10/10/2006
Last updated
02/09/2011
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