Healthcare Provider Details

I. General information

NPI: 1225545387
Provider Name (Legal Business Name): MEGAN HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 HARVEY RD
LONDONDERRY NH
03053-7449
US

IV. Provider business mailing address

1330 N 16TH ST
VINCENNES IN
47591-5802
US

V. Phone/Fax

Practice location:
  • Phone: 800-657-6517
  • Fax: 800-657-6517
Mailing address:
  • Phone: 606-495-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06005283A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: