Provider Demographics
NPI:1194280396
Name:MEYER, AMELIA LORRAINE
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:LORRAINE
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39203 COUNTY ROAD 186
Mailing Address - Street 2:
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-8365
Mailing Address - Country:US
Mailing Address - Phone:320-429-0651
Mailing Address - Fax:
Practice Address - Street 1:39203 COUNTY ROAD 186
Practice Address - Street 2:
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-8365
Practice Address - Country:US
Practice Address - Phone:320-429-0651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer