Provider Demographics
NPI:1457684888
Name:STONE, MEGAN (MSPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 WATT AVE STE B5
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0581
Mailing Address - Country:US
Mailing Address - Phone:916-483-8282
Mailing Address - Fax:916-483-6699
Practice Address - Street 1:2222 WATT AVE STE B5
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0581
Practice Address - Country:US
Practice Address - Phone:916-483-8282
Practice Address - Fax:916-483-6699
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist