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NPI Code Detail

MEDICARE: MEGAN RAND PT, DPT

MEDICARE: MEGAN RAND PT, DPT
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
1225100000XPhysical Therapist2013028624MO
2225100000XPhysical Therapist070021645IL

General Provider Information

NPI Number : 1538591169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN RAND PT, DPT
Provider Business Mailing Address
First Line : 101 W UNIVERSITY AVE
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61820-3909
Country : US
Telephone Number : 217-366-1323
Fax Number : 217-366-6106
Provider Business Practice Location Address
First Line : 3545 N VERMILION ST
Second Line :
City : DANVILLE
State : IL
Zip : 61832-1100
Country : US
Telephone Number : 217-442-8611
Fax Number : 217-366-6106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2013
Last Update Date : 11/18/2016

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