Provider Demographics
NPI:1437381712
Name:MOYERS, MEAGAN J (PT)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:J
Last Name:MOYERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 GAHAGAN RD
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-1515
Mailing Address - Country:US
Mailing Address - Phone:423-322-5149
Mailing Address - Fax:
Practice Address - Street 1:320 N HOLTZCLAW AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2305
Practice Address - Country:US
Practice Address - Phone:423-322-5149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1515550Medicaid
TN4236242OtherBLUECROSS BLUESHIELD
TN1031657128Medicare PIN