Provider Demographics
NPI:1114572617
Name:REDMOND, MEGAN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:REDMOND
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 HARTLEY CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-9029
Mailing Address - Country:US
Mailing Address - Phone:606-831-4031
Mailing Address - Fax:
Practice Address - Street 1:1100 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:FLATWOODS
Practice Address - State:KY
Practice Address - Zip Code:41139-1024
Practice Address - Country:US
Practice Address - Phone:606-836-3187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007734225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist