Individual ProviderTina MeyerPhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1040 Pilgrim Way, Green Bay, WI 54304-5028(920) 405-3522(920) 496-0304PECOS EnrollmentBased on the most recent information from CMS, provider Tina Meyer does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1982717898Provider TypeIndividualFull NameMeyer, TinaGenderFemaleSole ProprietorNoEnumeration Date8/16/2006Last Updated3/6/2012Contact InformationPractice LocationPractice Address1040 Pilgrim Way, Green Bay, WI 54304-5028Phone(920) 405-3522FaxUnlisted FaxMailing LocationMailing Address420 Whispering Creek Ct, Green Bay, WI 54303-6029Phone(920) 496-0304FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225200000XPrimaryDescriptionPhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense449-19Provider IdentifiersIDDescriptionIssuerID40317600DescriptionMedicaidIssuerUnlistedWisconsin