Provider Demographics
NPI:1740591031
Name:ELEID, MEGAN (DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ELEID
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:MAZUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2746 SUPERIOR DR NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-8343
Mailing Address - Country:US
Mailing Address - Phone:507-288-0064
Mailing Address - Fax:
Practice Address - Street 1:2746 SUPERIOR DR NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-8343
Practice Address - Country:US
Practice Address - Phone:507-288-0064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8495225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist