Provider Demographics
NPI:1194983890
Name:DAVIS, MEGAN LYN (LMT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
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Mailing Address - Street 1:15439 27TH CT E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-1842
Mailing Address - Country:US
Mailing Address - Phone:941-284-2023
Mailing Address - Fax:941-209-5296
Practice Address - Street 1:8109 COOPER CREEK BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-2004
Practice Address - Country:US
Practice Address - Phone:941-366-1168
Practice Address - Fax:941-360-1125
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLMA53120173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist