Provider Demographics
NPI:1841420015
Name:DAVIS, MEGHAN ELIZABETH (DPT)
Entity Type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 ROSS HILL RD
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-5201
Mailing Address - Country:US
Mailing Address - Phone:607-341-1074
Mailing Address - Fax:
Practice Address - Street 1:18 BROAD ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2106
Practice Address - Country:US
Practice Address - Phone:607-798-7117
Practice Address - Fax:607-798-0074
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031482-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist