Provider Demographics
NPI:1952843583
Name:WHITE, MEAGHAN TANGUAY (DPT)
Entity Type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:TANGUAY
Last Name:WHITE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:
Other - Last Name:TANGUAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:471 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2822
Mailing Address - Country:US
Mailing Address - Phone:506-667-7013
Mailing Address - Fax:
Practice Address - Street 1:5 N MEADOWS RD
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2317
Practice Address - Country:US
Practice Address - Phone:508-359-9119
Practice Address - Fax:508-359-9115
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22404225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist