Provider Demographics
NPI:1114475134
Name:GREGOIRE, MEGHAN (DPT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:GREGOIRE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:HENNESSY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-751-3373
Mailing Address - Fax:
Practice Address - Street 1:2352 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9203
Practice Address - Country:US
Practice Address - Phone:813-751-3373
Practice Address - Fax:813-377-1697
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29842225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist