Provider Demographics
NPI:1962669606
Name:CHESSER, MEGAN ELIZABETH (LMT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:CHESSER
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 1:12830 SW 1ST LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3260
Mailing Address - Country:US
Mailing Address - Phone:352-692-2131
Mailing Address - Fax:
Practice Address - Street 1:12830 SW 1ST LN
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3260
Practice Address - Country:US
Practice Address - Phone:352-692-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA52911225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist