Healthcare Provider Details

I. General information

NPI: 1568041846
Provider Name (Legal Business Name): MEGAN ANDERSON PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32830 DIONIS DR
LEWES DE
19958-5860
US

IV. Provider business mailing address

32830 DIONIS DR
LEWES DE
19958-5860
US

V. Phone/Fax

Practice location:
  • Phone: 317-446-8047
  • Fax:
Mailing address:
  • Phone: 317-446-8047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MEGAN ANDERSON
Title or Position: OWNER/ PROVIDER
Credential: DPT
Phone: 317-446-8047