Provider Demographics
NPI:1447509906
Name:ROEMER, MEGAN B (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:B
Last Name:ROEMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:B
Other - Last Name:KOSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1100 CLUB VILLAGE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4409
Mailing Address - Country:US
Mailing Address - Phone:573-256-2777
Mailing Address - Fax:
Practice Address - Street 1:1100 CLUB VILLAGE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4409
Practice Address - Country:US
Practice Address - Phone:573-256-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012030572225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist