Healthcare Provider Details

I. General information

NPI: 1063165637
Provider Name (Legal Business Name): MEGAN MEFFORD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 OLD WHITLEY RD
LONDON KY
40744-8211
US

IV. Provider business mailing address

181 OLD WHITLEY RD
LONDON KY
40744-8211
US

V. Phone/Fax

Practice location:
  • Phone: 606-330-0223
  • Fax:
Mailing address:
  • Phone: 606-330-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number275020
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: