Provider Demographics
NPI:1689446858
Name:QUINLAN, MEAGHAN (PTA, LMT)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:
Last Name:QUINLAN
Suffix:
Gender:F
Credentials:PTA, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SACO ISLAND TER UNIT 319
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3560
Mailing Address - Country:US
Mailing Address - Phone:207-751-2357
Mailing Address - Fax:
Practice Address - Street 1:245 GORHAM RD
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9558
Practice Address - Country:US
Practice Address - Phone:207-413-3592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA5717225200000X
MEMT7519225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant