Provider Demographics
NPI:1790211563
Name:TRICE, MEAGEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:MEAGEN
Middle Name:
Last Name:TRICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MEAGEN
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:205 LONDON LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-4421
Mailing Address - Country:US
Mailing Address - Phone:615-614-8833
Mailing Address - Fax:615-614-8811
Practice Address - Street 1:508 AUTUMN SPRINGS CT
Practice Address - Street 2:STE A
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8272
Practice Address - Country:US
Practice Address - Phone:615-614-8833
Practice Address - Fax:615-614-8811
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11154225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist