Provider Demographics
NPI:1003598624
Name:COHEN, MEAGAN (PT)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WILLOW LAWN DR STE 230
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3003
Mailing Address - Country:US
Mailing Address - Phone:804-340-1193
Mailing Address - Fax:
Practice Address - Street 1:1700 WILLOW LAWN DR STE 230
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3003
Practice Address - Country:US
Practice Address - Phone:804-340-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215923225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist