Healthcare Provider Details

I. General information

NPI: 1265032098
Provider Name (Legal Business Name): MEGAN THERESE TRUDELL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN THERESE SAIGH

II. Dates (important events)

Enumeration Date: 10/30/2020
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 W 14 MILE RD STE B2
CLAWSON MI
48017-3100
US

IV. Provider business mailing address

555 W 14 MILE RD STE B2
CLAWSON MI
48017-3100
US

V. Phone/Fax

Practice location:
  • Phone: 248-733-3885
  • Fax: 248-566-0098
Mailing address:
  • Phone: 248-733-3885
  • Fax: 248-566-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501019801
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: