Provider Demographics
NPI:1972170173
Name:DEWALT, MEGAN (RDH, OMT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DEWALT
Suffix:
Gender:F
Credentials:RDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 OSAGE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3525
Mailing Address - Country:US
Mailing Address - Phone:312-498-9389
Mailing Address - Fax:
Practice Address - Street 1:3318 OSAGE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3525
Practice Address - Country:US
Practice Address - Phone:312-498-9389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist