Provider Demographics
NPI:1760925788
Name:KAISER, MEGAN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:KAISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 DOVECREST CT
Mailing Address - Street 2:3
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-7839
Mailing Address - Country:US
Mailing Address - Phone:615-519-9873
Mailing Address - Fax:
Practice Address - Street 1:8305 DOVECREST CT
Practice Address - Street 2:3
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-7839
Practice Address - Country:US
Practice Address - Phone:615-519-9873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006661225100000X
FLPT31570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist