Provider Demographics
NPI:1427313774
Name:LEGMEG, CHARLES (MS, ATC, LAT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:
Last Name:LEGMEG
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 KETLER ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79104-3317
Mailing Address - Country:US
Mailing Address - Phone:806-206-7849
Mailing Address - Fax:
Practice Address - Street 1:3001 SE 34TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103-5599
Practice Address - Country:US
Practice Address - Phone:806-326-2200
Practice Address - Fax:806-371-6042
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT50232255A2300X
NE20000073252255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer