Healthcare Provider Details

I. General information

NPI: 1265776611
Provider Name (Legal Business Name): MEGAN LYNN ST. ONGE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2012
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 DANIEL WEBSTER HWY
BOSCAWEN NH
03303-2415
US

IV. Provider business mailing address

64 WHITE BIRCH RD
HENNIKER NH
03242-3448
US

V. Phone/Fax

Practice location:
  • Phone: 603-796-2165
  • Fax:
Mailing address:
  • Phone: 603-660-2332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3479
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number3479
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: