Provider Demographics
NPI:1922497841
Name:ANTHONY, MEGAN (ATC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6061 COLONIAL PKWY
Mailing Address - Street 2:APT. 7104
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-2575
Mailing Address - Country:US
Mailing Address - Phone:740-403-8746
Mailing Address - Fax:
Practice Address - Street 1:4555 N SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6403
Practice Address - Country:US
Practice Address - Phone:740-403-8746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer