Provider Demographics
NPI:1558536334
Name:EGGEN, MARGARET DE CHANT (PTA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:DE CHANT
Last Name:EGGEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:DECHANT
Other - Last Name:BAFFA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1419 EDGEVALE RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-2307
Mailing Address - Country:US
Mailing Address - Phone:573-418-0922
Mailing Address - Fax:
Practice Address - Street 1:957 BECKS KNOB RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8800
Practice Address - Country:US
Practice Address - Phone:740-653-9481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06729225200000X
225200000X
MO2009011800225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant