Provider Demographics
NPI:1639783681
Name:HAMPTON, MEGHAN VERONICA (LAT, MA, ATC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:VERONICA
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:LAT, MA, ATC
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:VERONICA
Other - Last Name:MALINOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, ATC
Mailing Address - Street 1:9151 CEDAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8893
Mailing Address - Country:US
Mailing Address - Phone:734-718-5082
Mailing Address - Fax:
Practice Address - Street 1:13245 NEWBURGH RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-5011
Practice Address - Country:US
Practice Address - Phone:734-655-8240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-06
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI26010020102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer