Provider Demographics
NPI:1124190947
Name:BRAGG, MEEGHAN MICHELLE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:MEEGHAN
Middle Name:MICHELLE
Last Name:BRAGG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MEEGHAN
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3445 POST ROAD
Mailing Address - Street 2:J ARTHUR TRUDEAU MEMORIAL CENTER
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-7147
Mailing Address - Country:US
Mailing Address - Phone:401-739-2700
Mailing Address - Fax:401-737-8907
Practice Address - Street 1:3445 POST ROAD
Practice Address - Street 2:J ARTHUR TRUDEAU MEMORIAL CENTER
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-7147
Practice Address - Country:US
Practice Address - Phone:401-739-2700
Practice Address - Fax:401-737-8907
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI240093OtherBCBS
RI6400187OtherNEIGHBORHOOD HEALTH
RI6400187OtherUNITED HEALTHCARE
RIKC02260Medicaid
RI409040OtherBLUE CHIP
RI4224OtherNEIGH3