Provider Demographics
NPI:1588702831
Name:STOWE, MEGAN R (MSPT, CSCS, CMTPT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:R
Last Name:STOWE
Suffix:
Gender:F
Credentials:MSPT, CSCS, CMTPT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:S
Other - Last Name:ROWLANDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT CSCS CMTPT
Mailing Address - Street 1:17045 W. CAPITOL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005
Mailing Address - Country:US
Mailing Address - Phone:262-790-5775
Mailing Address - Fax:262-790-5710
Practice Address - Street 1:17045 W. CAPITOL DRIVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005
Practice Address - Country:US
Practice Address - Phone:262-790-5775
Practice Address - Fax:262-790-5710
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4481024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
392031168010OtherANTHEM BCBS
392031168010OtherANTHEM BCBS
WI000186697Medicare PIN