Provider Demographics
NPI:1083495634
Name:MARTIN, MEAGAN (LPTA)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:ELYSE
Other - Last Name:GRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:5840 MCASHAN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MC CALLA
Mailing Address - State:AL
Mailing Address - Zip Code:35111-4800
Mailing Address - Country:US
Mailing Address - Phone:256-736-4979
Mailing Address - Fax:
Practice Address - Street 1:235 INVERNESS CENTER DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35242-4805
Practice Address - Country:US
Practice Address - Phone:205-443-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant