Provider Demographics
NPI:1891762241
Name:DESPRES, MEGAN E (MSPT, DPT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:DESPRES
Suffix:
Gender:F
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MARTIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 ORTHOPEDIC DR
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1668
Practice Address - Country:US
Practice Address - Phone:978-818-6260
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150402251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic