Provider Demographics
NPI:1821238015
Name:IRVING, MEGAN ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:ANN
Last Name:IRVING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23616 430TH ST
Mailing Address - Street 2:
Mailing Address - City:MORAVIA
Mailing Address - State:IA
Mailing Address - Zip Code:52571-8905
Mailing Address - Country:US
Mailing Address - Phone:641-895-2771
Mailing Address - Fax:641-932-1708
Practice Address - Street 1:6580 165TH ST
Practice Address - Street 2:
Practice Address - City:ALBIA
Practice Address - State:IA
Practice Address - Zip Code:52531-8793
Practice Address - Country:US
Practice Address - Phone:800-334-1919
Practice Address - Fax:402-334-6844
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00753225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant