Provider Demographics
NPI:1619148020
Name:ISAACS, MEGAN CHRISTINE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CHRISTINE
Last Name:ISAACS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:MEGAN
Other - Middle Name:CHRISTINE
Other - Last Name:TUOMINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:13224 ZION ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-1236
Mailing Address - Country:US
Mailing Address - Phone:763-670-3590
Mailing Address - Fax:
Practice Address - Street 1:825 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6846
Practice Address - Country:US
Practice Address - Phone:651-633-7875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant