Provider Demographics
NPI:1790442960
Name:BARTON, MEGAN K
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:K
Last Name:BARTON
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 1:1000 COUNTRY LN STE 400
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-3410
Mailing Address - Country:US
Mailing Address - Phone:906-486-2000
Mailing Address - Fax:
Practice Address - Street 1:1000 COUNTRY LN STE 400
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-3410
Practice Address - Country:US
Practice Address - Phone:906-486-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501002108225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist