Provider Demographics
NPI:1922668912
Name:SCHMUCKER, MEGAN (LMT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SCHMUCKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:8300 STATE ROUTE 609
Mailing Address - Street 2:
Mailing Address - City:BURGHILL
Mailing Address - State:OH
Mailing Address - Zip Code:44404-9788
Mailing Address - Country:US
Mailing Address - Phone:330-540-4205
Mailing Address - Fax:
Practice Address - Street 1:369 NILES CORTLAND RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2430
Practice Address - Country:US
Practice Address - Phone:330-856-9595
Practice Address - Fax:330-856-1411
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.019575225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist