Provider Demographics
NPI:1376980094
Name:SWAYNE, MEGAN (MS, ATC, AT, CES)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SWAYNE
Suffix:
Gender:F
Credentials:MS, ATC, AT, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 VINE ST APT A
Mailing Address - Street 2:
Mailing Address - City:PEEBLES
Mailing Address - State:OH
Mailing Address - Zip Code:45660-1236
Mailing Address - Country:US
Mailing Address - Phone:740-222-8018
Mailing Address - Fax:
Practice Address - Street 1:152 VINE ST APT A
Practice Address - Street 2:
Practice Address - City:PEEBLES
Practice Address - State:OH
Practice Address - Zip Code:45660-1236
Practice Address - Country:US
Practice Address - Phone:740-222-8018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT. 0034412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer