Provider Demographics
NPI:1386964799
Name:GARRISON, MEGAN E (PT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:E
Last Name:GARRISON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:20 OVERBROOK DR STE D
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1147
Mailing Address - Country:US
Mailing Address - Phone:513-539-2886
Mailing Address - Fax:877-430-7975
Practice Address - Street 1:20 OVERBROOK DR STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1147
Practice Address - Country:US
Practice Address - Phone:513-539-2886
Practice Address - Fax:877-430-7975
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT012810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHO34480Medicare UPIN