Healthcare Provider Details

I. General information

NPI: 1679753503
Provider Name (Legal Business Name): MEGAN TERESA LOSO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN PLOEHN

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 06/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 REIDVILLE RD STE 6 & 7
SPARTANBURG SC
29301-3512
US

IV. Provider business mailing address

103 N MAIN ST STE 300
GREENVILLE SC
29601-2796
US

V. Phone/Fax

Practice location:
  • Phone: 864-576-3738
  • Fax:
Mailing address:
  • Phone: 864-528-5700
  • Fax: 864-528-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5620
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: