MEDICARE: MEGHAN BRIANNA HARRIS PT

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	PT011557	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT011557	OTHER	GA	LICENSE NUMBER

General Provider Information

NPI Number	:	1942605589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN BRIANNA HARRIS PT

Provider Business Mailing Address
First Line	:	2800 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3987
Country	:	US
Telephone Number	:	470-427-3840
Fax Number	:	470-200-2818

Provider Business Practice Location Address
First Line	:	2800 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3987
Country	:	US
Telephone Number	:	470-427-3840
Fax Number	:	470-200-2818

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

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	07/26/2024

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