Provider Demographics
NPI:1245588227
Name:WATTS, MEGAN MCKINNEY (DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MCKINNEY
Last Name:WATTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 SILVERSIDE ROAD
Mailing Address - Street 2:SPRINGER BUILDING, SUITE 105
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-478-5240
Mailing Address - Fax:
Practice Address - Street 1:6411 SILVERSIDE ROAD
Practice Address - Street 2:SPRINGER BUILDING, SUITE 105
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:302-478-5240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG00716OtherFACILITY GROUP MEDICARE PIN
DE246511ZBSXMedicare PIN