Provider Demographics
NPI:1760822076
Name:MUNSELL, MEGAN READ (PT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:READ
Last Name:MUNSELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8100 WYOMING BLVD NE STE M4
Mailing Address - Street 2:#261
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1963
Mailing Address - Country:US
Mailing Address - Phone:505-797-5505
Mailing Address - Fax:505-797-5510
Practice Address - Street 1:7424 HOLLY AVE. NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113
Practice Address - Country:US
Practice Address - Phone:505-797-5505
Practice Address - Fax:505-797-5510
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM4256225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist