Provider Demographics
NPI:1447860119
Name:HARVEY, MEAGAN KELLIE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MEAGAN
Middle Name:KELLIE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-4306
Mailing Address - Country:US
Mailing Address - Phone:860-679-0430
Mailing Address - Fax:
Practice Address - Street 1:302 W MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-4306
Practice Address - Country:US
Practice Address - Phone:860-679-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12765225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist