Provider Demographics
NPI:1568587541
Name:LA MARCA, MEGHANN E (PT)
Entity Type:Individual
Prefix:
First Name:MEGHANN
Middle Name:E
Last Name:LA MARCA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MEGHANN
Other - Middle Name:E
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12361 W BOLA DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-9021
Mailing Address - Country:US
Mailing Address - Phone:623-977-1157
Mailing Address - Fax:623-977-1180
Practice Address - Street 1:14800 W MOUNTAIN VIEW BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4795
Practice Address - Country:US
Practice Address - Phone:623-556-5013
Practice Address - Fax:623-556-9290
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7220225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist