Provider Demographics
NPI:1265825301
Name:LEBOVITZ, MEGAN (AT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:LEBOVITZ
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ELLIOTT ST
Mailing Address - Street 2:APT. 110
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39 ELLIOTT ST
Practice Address - Street 2:APT. 110
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2690
Practice Address - Country:US
Practice Address - Phone:330-510-0239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer