Healthcare Provider Details

I. General information

NPI: 1881011468
Provider Name (Legal Business Name): MEAGAN WEBER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2014
Last Update Date: 03/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E SIGLER AVE SCOTLAND COUNTY HOSPITAL
MEMPHIS MO
63555-1726
US

IV. Provider business mailing address

450 E SIGLER AVE
MEMPHIS MO
63555-1726
US

V. Phone/Fax

Practice location:
  • Phone: 660-465-8511
  • Fax:
Mailing address:
  • Phone: 660-465-8511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2010019985
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: