Healthcare Provider Details

I. General information

NPI: 1235516535
Provider Name (Legal Business Name): MEGAN E KEHR ATC, N.H.LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 ROUTE 103
NEWBURY NH
03255-5803
US

IV. Provider business mailing address

PO BOX 209 895 ROUTE 103
NEWBURY NH
03255-0209
US

V. Phone/Fax

Practice location:
  • Phone: 603-763-2990
  • Fax: 603-763-2992
Mailing address:
  • Phone: 603-763-2990
  • Fax: 603-763-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0630
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: