Provider Demographics
NPI:1093995680
Name:CALOUDAS, MEGHANN CAREY (PT)
Entity Type:Individual
Prefix:MISS
First Name:MEGHANN
Middle Name:CAREY
Last Name:CALOUDAS
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 1:425 DARK TIMBER ST
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7349
Mailing Address - Country:US
Mailing Address - Phone:610-717-2211
Mailing Address - Fax:
Practice Address - Street 1:900 ISLAND PARK DR
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-7559
Practice Address - Country:US
Practice Address - Phone:843-284-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist