Provider Demographics
NPI:1033547112
Name:FISHER, MEGAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:FISHER
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 1:7080 DONLON WAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2787
Mailing Address - Country:US
Mailing Address - Phone:925-556-4310
Mailing Address - Fax:925-556-0375
Practice Address - Street 1:7080 DONLON WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2787
Practice Address - Country:US
Practice Address - Phone:925-556-4310
Practice Address - Fax:925-556-0375
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39682225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist