Provider Demographics
NPI:1982042099
Name:ALLEN, MEGEN LEIGH (PT)
Entity Type:Individual
Prefix:MRS
First Name:MEGEN
Middle Name:LEIGH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MEGEN
Other - Middle Name:LEIGH
Other - Last Name:DURKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:10909 HANNAN RD
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-1383
Mailing Address - Country:US
Mailing Address - Phone:734-893-1094
Mailing Address - Fax:734-893-3155
Practice Address - Street 1:10909 HANNAN RD
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-1383
Practice Address - Country:US
Practice Address - Phone:734-893-1094
Practice Address - Fax:734-893-3155
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist