Provider Demographics
NPI:1760936512
Name:SABOO, MEGHNA
Entity Type:Individual
Prefix:
First Name:MEGHNA
Middle Name:
Last Name:SABOO
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 1:1002 SHARVIEW CIR
Mailing Address - Street 2:APT 234
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-6602
Mailing Address - Country:US
Mailing Address - Phone:704-495-4087
Mailing Address - Fax:
Practice Address - Street 1:1004 ROSEWATER LN
Practice Address - Street 2:INDIAN TRAIL
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-3712
Practice Address - Country:US
Practice Address - Phone:704-606-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16426225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist