Provider Demographics
NPI:1104381508
Name:MEAGHER, EMMA (ATC)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:MEAGHER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:CO
Mailing Address - Zip Code:80615-9059
Mailing Address - Country:US
Mailing Address - Phone:970-978-0996
Mailing Address - Fax:
Practice Address - Street 1:209 SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5025
Practice Address - Country:US
Practice Address - Phone:314-596-2656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-10
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program