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General NPI Number Information
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NPI Number | 1255087011
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Entity Type | Individual
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Provider Name | MEGHAN MCINNIS DPT
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Gender | Female
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Dates
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Enumeration Date | 03/01/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 1050 DIVISION ST
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City | MAUSTON
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State | WI
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Zip | 53948-1931
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Country | US
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Telephone | 608-847-1290
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Fax |
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Provider Business Mailing Address
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Address Line | 123 RIDGE RUN LN
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City | CARENCRO
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State | LA
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Zip | 70520-6471
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10609
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License Number State | LA
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