Provider Demographics
NPI:1366809626
Name:MEERS, TEELA DAWN (LMT)
Entity type:Individual
Prefix:
First Name:TEELA
Middle Name:DAWN
Last Name:MEERS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 E WADE WATTS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5647
Mailing Address - Country:US
Mailing Address - Phone:918-916-7234
Mailing Address - Fax:
Practice Address - Street 1:1308 E WADE WATTS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5647
Practice Address - Country:US
Practice Address - Phone:918-916-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6214225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist