Healthcare Provider Details

I. General information

NPI: 1053226365
Provider Name (Legal Business Name): MEGAN LYNN WELLS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 CONSTITUTION AVE
OLEAN NY
14760-1840
US

IV. Provider business mailing address

2416 CONSTITUTION AVE
OLEAN NY
14760-1840
US

V. Phone/Fax

Practice location:
  • Phone: 716-372-2808
  • Fax:
Mailing address:
  • Phone: 716-372-2808
  • Fax: 716-372-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056537
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT034540
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: