Provider Demographics
NPI:1629403886
Name:DUNCAN, MEAGAN E (DPT)
Entity Type:Individual
Prefix:
First Name:MEAGAN
Middle Name:E
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEAGAN
Other - Middle Name:E
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7125 GRAND MONTECITO PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0261
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7125 GRAND MONTECITO PKWY STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0261
Practice Address - Country:US
Practice Address - Phone:815-744-7108
Practice Address - Fax:815-744-7057
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1169225200000X
NV4300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant