Provider Demographics
NPI:1447481296
Name:ANDERSON, MEGAN ANN (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32830 DIONIS DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5860
Mailing Address - Country:US
Mailing Address - Phone:317-446-8047
Mailing Address - Fax:
Practice Address - Street 1:32830 DIONIS DR
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-5860
Practice Address - Country:US
Practice Address - Phone:317-446-8047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210012225100000X, 225100000X
DEJ1-0002881225100000X
DC871871225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist