Provider Demographics
NPI:1508142761
Name:DARCY, MEGAN LEIGH (ATC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEIGH
Last Name:DARCY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ACADEMY RD
Mailing Address - Street 2:#78
Mailing Address - City:CULVER
Mailing Address - State:IN
Mailing Address - Zip Code:46511-1234
Mailing Address - Country:US
Mailing Address - Phone:231-670-7682
Mailing Address - Fax:
Practice Address - Street 1:1300 ACADEMY RD
Practice Address - Street 2:#78
Practice Address - City:CULVER
Practice Address - State:IN
Practice Address - Zip Code:46511-1234
Practice Address - Country:US
Practice Address - Phone:231-670-7682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001847A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer