Healthcare Provider Details

I. General information

NPI: 1114966975
Provider Name (Legal Business Name): MEGHAN MAUREEN DENIS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E NEWPORT AVE
MILWAUKEE WI
53211-2906
US

IV. Provider business mailing address

1940 N PROSPECT AVE #21
MILWAUKEE WI
53202-1493
US

V. Phone/Fax

Practice location:
  • Phone: 414-291-4164
  • Fax:
Mailing address:
  • Phone: 414-810-4156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number10499-024
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number10499-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: