Healthcare Provider Details

I. General information

NPI: 1649687203
Provider Name (Legal Business Name): MEGAN MCLENDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1807 W MOLINE ST
MALVERN AR
72104-2645
US

IV. Provider business mailing address

6016 CASTLE ROCK DR
BENTON AR
72019-7401
US

V. Phone/Fax

Practice location:
  • Phone: 870-317-6238
  • Fax:
Mailing address:
  • Phone: 870-317-6238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA 3807
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: