Provider Demographics
NPI:1447480124
Name:FRAZEE, MEGAN MICHELLE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MICHELLE
Last Name:FRAZEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WINCHESTER CT
Mailing Address - Street 2:#1
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-3737
Mailing Address - Country:US
Mailing Address - Phone:785-562-7656
Mailing Address - Fax:
Practice Address - Street 1:40 BEACH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1468
Practice Address - Country:US
Practice Address - Phone:978-526-8288
Practice Address - Fax:978-526-7084
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189832251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic