Provider Demographics
NPI:1134998784
Name:MAJESKI, MEGHAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:MAJESKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 N FERDON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-2170
Mailing Address - Country:US
Mailing Address - Phone:850-331-3017
Mailing Address - Fax:855-275-2575
Practice Address - Street 1:1987 HIGHWAY 87
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-1046
Practice Address - Country:US
Practice Address - Phone:850-710-7163
Practice Address - Fax:855-975-2471
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40991225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist