Provider Demographics
NPI:1497590368
Name:REDMOND, MEGHAN ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:REDMOND
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 1:31 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1124
Mailing Address - Country:US
Mailing Address - Phone:973-908-5522
Mailing Address - Fax:
Practice Address - Street 1:7764 ARMISTEAD RD STE 210
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1961
Practice Address - Country:US
Practice Address - Phone:703-546-0013
Practice Address - Fax:703-546-0014
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02260000261QP2000X
VACP032446T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy