Provider Demographics
NPI:1962709121
Name:STINSON, MEGAN DANCE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DANCE
Last Name:STINSON
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 1:702 W HIGHWAY 25 70
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-9020
Mailing Address - Country:US
Mailing Address - Phone:423-225-2554
Mailing Address - Fax:423-458-2117
Practice Address - Street 1:702 W HIGHWAY 25 70
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-9020
Practice Address - Country:US
Practice Address - Phone:423-225-2554
Practice Address - Fax:423-458-2117
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist