Provider Demographics
NPI:1518165752
Name:DAY, MEGAN RENEA (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:RENEA
Last Name:DAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SE J ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4185
Mailing Address - Country:US
Mailing Address - Phone:479-273-0225
Mailing Address - Fax:479-273-9630
Practice Address - Street 1:2200 SE J ST
Practice Address - Street 2:SUITE 14
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-4185
Practice Address - Country:US
Practice Address - Phone:479-273-0225
Practice Address - Fax:479-273-9630
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6136174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist