Provider Demographics
NPI:1396700530
Name:ATWOOD, MEREDITH ANN (MS, ATC, LAT)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANN
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 DAYTON BLVD
Mailing Address - Street 2:APT D68
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-7120
Mailing Address - Country:US
Mailing Address - Phone:423-322-7235
Mailing Address - Fax:
Practice Address - Street 1:900 MOUNTAIN CREEK RD
Practice Address - Street 2:APT K140
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4500
Practice Address - Country:US
Practice Address - Phone:423-322-7235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0010272255A2300X
TNAT00000008402255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer