Provider Demographics
NPI:1386903839
Name:NICHOLS, MEGHAN ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:NICHOLS
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 1:45 OLD SOLOMONS ISLAND RD
Mailing Address - Street 2:STE 205
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3800
Mailing Address - Country:US
Mailing Address - Phone:410-224-4348
Mailing Address - Fax:410-224-4348
Practice Address - Street 1:219 BRYANT ST
Practice Address - Street 2:PHYSICAL THERAPY DEPARTMENT
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-878-7470
Practice Address - Fax:716-878-1157
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031061-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist