Provider Demographics
NPI:1962720573
Name:MEADOWS, JAMES II (COTA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:MEADOWS
Suffix:II
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 E CANTRELL ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62521-3647
Mailing Address - Country:US
Mailing Address - Phone:406-250-1562
Mailing Address - Fax:
Practice Address - Street 1:1630 E CANTRELL ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-3647
Practice Address - Country:US
Practice Address - Phone:406-250-1562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1728224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant