Provider Demographics
NPI:1588213201
Name:SWEGAR, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SWEGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 439
Mailing Address - Street 2:
Mailing Address - City:METLAKATLA
Mailing Address - State:AK
Mailing Address - Zip Code:99926-0439
Mailing Address - Country:US
Mailing Address - Phone:907-617-4555
Mailing Address - Fax:
Practice Address - Street 1:563 BRENDIBLE ST
Practice Address - Street 2:
Practice Address - City:METLAKATLA
Practice Address - State:AK
Practice Address - Zip Code:99926
Practice Address - Country:US
Practice Address - Phone:907-886-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK144369225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist