MEDICARE: MEGAN BETH MCKOY D.P.T.

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	8192	AZ
2	225100000X	Physical Therapist	2865	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8192	OTHER	AZ	AZ LICENSE

General Provider Information

NPI Number	:	1871730176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN BETH MCKOY D.P.T.

Provider Business Mailing Address
First Line	:	8205 W WARM SPRINGS RD
Second Line	:	SUITE 250
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3645
Country	:	US
Telephone Number	:	702-734-4901
Fax Number	:

Provider Business Practice Location Address
First Line	:	8205 W WARM SPRINGS RD
Second Line	:	SUITE 250
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3645
Country	:	US
Telephone Number	:	702-734-4901
Fax Number	:

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

Provider Enumeration Date	:	01/08/2009
Last Update Date	:	06/30/2016

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