Healthcare Provider Details

I. General information

NPI: 1568982890
Provider Name (Legal Business Name): MEGAN ANN-MELUGIN ROBERTS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN ANN MELUGIN PT, DPT

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1839 E INDEPENDENCE ST UNIT R
SPRINGFIELD MO
65804-3753
US

IV. Provider business mailing address

3223 N WEBB RD STE 2
WICHITA KS
67226-8176
US

V. Phone/Fax

Practice location:
  • Phone: 417-708-5174
  • Fax:
Mailing address:
  • Phone: 423-238-7217
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-05672
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2017027091
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: