Healthcare Provider Details

I. General information

NPI: 1447480124
Provider Name (Legal Business Name): MEGAN MICHELLE FRAZEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 06/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BEACH ST SUITE 101
MANCHESTER MA
01944-1468
US

IV. Provider business mailing address

4 WINCHESTER CT #1
GLOUCESTER MA
01930-3737
US

V. Phone/Fax

Practice location:
  • Phone: 978-526-8288
  • Fax: 978-526-7084
Mailing address:
  • Phone: 785-562-7656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number18983
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: