Provider Demographics
NPI:1194931899
Name:MEYER, REDA E (CMT)
Entity type:Individual
Prefix:MRS
First Name:REDA
Middle Name:E
Last Name:MEYER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11365 ROCK DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-8823
Mailing Address - Country:US
Mailing Address - Phone:269-795-2182
Mailing Address - Fax:
Practice Address - Street 1:5060 CASCADE RD SE STE C
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3808
Practice Address - Country:US
Practice Address - Phone:616-610-1097
Practice Address - Fax:616-940-4594
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor