Provider Demographics
NPI:1134683253
Name:HOTALING, MEGHAN CATHERINE
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:CATHERINE
Last Name:HOTALING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SOPER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CROSS ROADS
Mailing Address - State:PA
Mailing Address - Zip Code:16914-8114
Mailing Address - Country:US
Mailing Address - Phone:607-237-8772
Mailing Address - Fax:
Practice Address - Street 1:151 KEEFER LN
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-7967
Practice Address - Country:US
Practice Address - Phone:570-888-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT02439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist