MEDICARE: MEGAN R VLASIC PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P15955	NC

General Provider Information

NPI Number	:	1225343114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN R VLASIC PT, DPT

Provider Business Mailing Address
First Line	:	800 CRESCENT CENTRE DR
Second Line	:	SUITE 600
City	:	FRANKLIN
State	:	TN
Zip	:	37067-7269
Country	:	US
Telephone Number	:	615-373-1350
Fax Number	:	615-221-9054

Provider Business Practice Location Address
First Line	:	11201 GALLERIA AVE
Second Line	:	SUITE 105
City	:	RALEIGH
State	:	NC
Zip	:	27614-8137
Country	:	US
Telephone Number	:	919-670-3350
Fax Number	:	919-670-3351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	01/22/2018

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