Provider Demographics
NPI:1659657310
Name:KLUNK, MEGHAN (DPT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:KLUNK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-9324
Mailing Address - Country:US
Mailing Address - Phone:717-586-5123
Mailing Address - Fax:
Practice Address - Street 1:10 WILLIAM POPE DR
Practice Address - Street 2:SUITE 3
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-7549
Practice Address - Country:US
Practice Address - Phone:843-705-9440
Practice Address - Fax:843-705-9445
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60221947225100000X
SC7360225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist