Provider Demographics
NPI:1407187206
Name:HARTMAN, MEGAN ALEXANDRA (CMT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ALEXANDRA
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ALEXANDRA
Other - Last Name:LINDSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 COOPER AVE N STE 160
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4446
Mailing Address - Country:US
Mailing Address - Phone:320-310-4000
Mailing Address - Fax:320-253-1575
Practice Address - Street 1:203 COOPER AVE N STE 160
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4446
Practice Address - Country:US
Practice Address - Phone:320-310-4000
Practice Address - Fax:320-253-1575
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist