Provider Demographics
NPI:1114278611
Name:MCCARTY, MEGAN L (PT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:L
Last Name:MCCARTY
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 1:16572 W GREENWAY RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-2183
Mailing Address - Country:US
Mailing Address - Phone:623-584-3400
Mailing Address - Fax:623-584-5434
Practice Address - Street 1:16572 W GREENWAY RD STE 103
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-2183
Practice Address - Country:US
Practice Address - Phone:623-584-3400
Practice Address - Fax:623-584-5434
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9962225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ93451Medicare PIN