Provider Demographics
NPI:1326183567
Name:MESKE SPORTS & PHYSICAL THERAPY
Entity type:Organization
Organization Name:MESKE SPORTS & PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:MESKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:254-776-3070
Mailing Address - Street 1:611 W STATE HIGHWAY 6
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7544
Mailing Address - Country:US
Mailing Address - Phone:254-776-3070
Mailing Address - Fax:254-776-7909
Practice Address - Street 1:611 W STATE HIGHWAY 6
Practice Address - Street 2:SUITE 101
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7544
Practice Address - Country:US
Practice Address - Phone:254-776-3070
Practice Address - Fax:254-776-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10933342251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty