Provider Demographics
NPI:1497002000
Name:MILLER, MEGAN MCKENZIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:MCKENZIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18863
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8863
Mailing Address - Country:US
Mailing Address - Phone:256-883-1970
Mailing Address - Fax:256-883-8061
Practice Address - Street 1:4240 BALMORAL DR SW
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6440
Practice Address - Country:US
Practice Address - Phone:256-883-1970
Practice Address - Fax:256-883-8061
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH6556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist