Healthcare Provider Details

I. General information

NPI: 1003125345
Provider Name (Legal Business Name): MEGHAN D DOYLE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3119 CRANBERRY HWY
EAST WAREHAM MA
02538-4840
US

IV. Provider business mailing address

3119 CRANBERRY HWY
EAST WAREHAM MA
02538-4840
US

V. Phone/Fax

Practice location:
  • Phone: 781-962-2445
  • Fax:
Mailing address:
  • Phone: 508-759-5411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number19295
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6625
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: