Provider Demographics
NPI:1538245048
Name:PEETERS GEBLER, MEAGAN (PT DPT)
Entity type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:
Last Name:PEETERS GEBLER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:
Other - Last Name:PEETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1511 S COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4801
Mailing Address - Country:US
Mailing Address - Phone:920-720-0660
Mailing Address - Fax:920-720-0666
Practice Address - Street 1:1511 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4801
Practice Address - Country:US
Practice Address - Phone:920-720-0660
Practice Address - Fax:920-720-0666
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10701-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1538245048Medicaid
860300026Medicare PIN
WI1538245048Medicaid