MEDICARE: MEGHAN R GENDZIER 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	CP036662T	GA
2	225100000X	Physical Therapist	PT33244	FL
3	225100000X	Physical Therapist	2305211773	VA
4	225100000X	Physical Therapist	CP025756T	AZ
5	225100000X	Physical Therapist	CP052956T	TN

General Provider Information

NPI Number	:	1639670177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN R GENDZIER PT, DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 N MARKET ST STE 102
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-4438
Country	:	US
Telephone Number	:	423-634-1922
Fax Number	:

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

Provider Enumeration Date	:	02/21/2018
Last Update Date	:	02/09/2026

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