Healthcare Provider Details

I. General information

NPI: 1023272754
Provider Name (Legal Business Name): MEGAN M GESELL PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN MOSHER PT

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BLVD SUITE 200
HERMITAGE TN
37076-2054
US

IV. Provider business mailing address

3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US

V. Phone/Fax

Practice location:
  • Phone: 615-885-0200
  • Fax: 615-885-0267
Mailing address:
  • Phone: 615-851-6033
  • Fax: 615-851-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8119
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0000008119
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: