Provider Demographics
NPI:1518276534
Name:SMITH, MEGAN ELYSE (DPT)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELYSE
Last Name:SMITH
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 1:623 S CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2315
Mailing Address - Country:US
Mailing Address - Phone:610-543-1201
Mailing Address - Fax:610-328-5205
Practice Address - Street 1:623 S CHESTER RD
Practice Address - Street 2:
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2315
Practice Address - Country:US
Practice Address - Phone:610-543-1201
Practice Address - Fax:610-328-5205
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023336225100000X
MEPT3671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist