Provider Demographics
NPI:1497985865
Name:THEILING, MEGAN MICHELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MICHELLE
Last Name:THEILING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MICHELLE
Other - Last Name:ENGELHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:13847 W 63RD ST
Practice Address - Street 2:STE 2
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-3800
Practice Address - Country:US
Practice Address - Phone:913-962-7774
Practice Address - Fax:913-962-7775
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009024857225100000X
KS11-05502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist