Provider Demographics
NPI:1558953455
Name:FORTIN, MEGAN (ND)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:FORTIN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-5251
Mailing Address - Country:US
Mailing Address - Phone:860-533-0179
Mailing Address - Fax:866-603-4164
Practice Address - Street 1:315 E CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5251
Practice Address - Country:US
Practice Address - Phone:860-533-0179
Practice Address - Fax:866-603-4164
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath