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General NPI Number Information
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NPI Number | 1508946617
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Entity Type | Individual
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Provider Name | MEGAN CLEM P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 1420 MAIN ST
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City | WOODWARD
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State | OK
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Zip | 73801-3004
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Country | US
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Telephone | 580-254-9111
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Fax | 866-359-3370
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Provider Business Mailing Address
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Address Line | 4416 THE RANCH RD
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City | EDMOND
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State | OK
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Zip | 73034-5090
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Country | US
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Telephone | 405-922-1860
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Fax | 866-664-3806
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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 | 3919
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License Number State | OK
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