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NPI Code Detail

MEDICARE: MRS. MEGAN MARIE SMITH

MEDICARE: MRS. MEGAN MARIE SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistKS

General Provider Information

NPI Number : 1467229914
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEGAN MARIE SMITH
Provider Business Mailing Address
First Line : 101 WILLOW LN
Second Line :
City : PERRY
State : KS
Zip : 66073-4106
Country : US
Telephone Number : 785-840-8212
Fax Number :
Provider Business Practice Location Address
First Line : 5040 BOB BILLINGS PKWY STE A2
Second Line :
City : LAWRENCE
State : KS
Zip : 66049-3843
Country : US
Telephone Number : 785-338-6619
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2023
Last Update Date : 12/05/2023

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Directions to “ MRS. MEGAN MARIE SMITH ” Practice Location

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