Healthcare Provider Details

I. General information

NPI: 1649744319
Provider Name (Legal Business Name): MEGAN ELIZABETH CALDERWOOD ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2019
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N DOBSON RD
SCOTTSDALE AZ
85256-2768
US

IV. Provider business mailing address

601 W RIO SALADO PKWY APT 1065
TEMPE AZ
85281-0108
US

V. Phone/Fax

Practice location:
  • Phone: 480-733-7400
  • Fax:
Mailing address:
  • Phone: 717-525-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberATR-009225
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: