Basic Information
| Provider Information | |||||||||
| NPI: | 1891911418 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEEK | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2241 FOOTHILL BLVD | ||||||||
| Address2: | SUITE 602 | ||||||||
| City: | ROCK SPRINGS | ||||||||
| State: | WY | ||||||||
| PostalCode: | 829015698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3073827888 | ||||||||
| FaxNumber: | 3073827444 | ||||||||
| Practice Location | |||||||||
| Address1: | 1380 E MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | ST GEORGE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 847902123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4352511000 | ||||||||
| FaxNumber: | 4356885681 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2007 | ||||||||
| LastUpdateDate: | 12/10/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 119452-2401 | UT | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 1555 | WY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.