Provider Demographics
NPI:1902037757
Name:O'BRIEN, MEGHAN LEIGH (LMT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:LEIGH
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 RINGLING BLVD
Mailing Address - Street 2:SUITE 104-A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5334
Mailing Address - Country:US
Mailing Address - Phone:941-915-2681
Mailing Address - Fax:
Practice Address - Street 1:2831 RINGLING BLVD
Practice Address - Street 2:SUITE 104-A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5334
Practice Address - Country:US
Practice Address - Phone:941-915-2681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 46539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist