Provider Demographics
NPI:1285732461
Name:MCMAHAN, MEGAN RENEE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:RENEE
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21672 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66083-7542
Mailing Address - Country:US
Mailing Address - Phone:620-496-6823
Mailing Address - Fax:785-229-8344
Practice Address - Street 1:901 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3315
Practice Address - Country:US
Practice Address - Phone:785-229-8343
Practice Address - Fax:785-229-8344
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist