Provider Demographics
NPI:1386217453
Name:KASPERSKI, MEGAN B (DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:B
Last Name:KASPERSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 RENAISSANCE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-7612
Mailing Address - Country:US
Mailing Address - Phone:724-256-9606
Mailing Address - Fax:724-256-9609
Practice Address - Street 1:1701 3RD ST STE 4
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2432
Practice Address - Country:US
Practice Address - Phone:878-207-2192
Practice Address - Fax:878-207-2193
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist