Healthcare Provider Details

I. General information

NPI: 1609139609
Provider Name (Legal Business Name): MEGAN MUSICK M.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN PFLEGER

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 E ASHLAND AVE
MT ZION IL
62549-1271
US

IV. Provider business mailing address

2335 S FILE DR
DECATUR IL
62521-9432
US

V. Phone/Fax

Practice location:
  • Phone: 217-864-2665
  • Fax: 217-864-8042
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.018554
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: