Provider Demographics
NPI:1679195473
Name:ROSS-HARRIS, MEGAN (LMT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ROSS-HARRIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:745 BOWLING BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-5213
Mailing Address - Country:US
Mailing Address - Phone:606-401-8658
Mailing Address - Fax:
Practice Address - Street 1:1978 S HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-7514
Practice Address - Country:US
Practice Address - Phone:606-401-8658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY162823225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty