Provider Demographics
NPI:1699522409
Name:BROWN, MEGAN LEIGH (PTA)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 BELLFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-7808
Mailing Address - Country:US
Mailing Address - Phone:816-585-2015
Mailing Address - Fax:
Practice Address - Street 1:SOLSTICE SENIOR LIVING
Practice Address - Street 2:1098 NE INDEPENDENCE AVE
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086
Practice Address - Country:US
Practice Address - Phone:816-271-3474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012025871225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant