Provider Demographics
NPI:1508299983
Name:GARNER, MEGAN RENEE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:RENEE
Last Name:GARNER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3464 FIELDSTONE DR
Mailing Address - Street 2:APARTMENT 2435
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-8287
Mailing Address - Country:US
Mailing Address - Phone:317-946-2931
Mailing Address - Fax:
Practice Address - Street 1:4895 PINE RIDGE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-2569
Practice Address - Country:US
Practice Address - Phone:812-342-5023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06004560A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant