Provider Demographics
NPI:1205061025
Name:HUBBARD, MEGAN E (DPT)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:E
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:GARRISONVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22463-0303
Mailing Address - Country:US
Mailing Address - Phone:540-907-1673
Mailing Address - Fax:
Practice Address - Street 1:6 MARQUIS CT
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8818
Practice Address - Country:US
Practice Address - Phone:540-907-1673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005885174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist