Provider Demographics
NPI:1508144460
Name:DUSENBERRY, MEGAN (DPT)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:DUSENBERRY
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 1:6206 E PIMA ST
Mailing Address - Street 2:#3
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-7000
Mailing Address - Country:US
Mailing Address - Phone:520-733-6227
Mailing Address - Fax:520-733-7328
Practice Address - Street 1:6206 E PIMA ST
Practice Address - Street 2:#3
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-7000
Practice Address - Country:US
Practice Address - Phone:520-733-6227
Practice Address - Fax:520-733-7328
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9412225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist