Provider Demographics
NPI:1649425059
Name:WELLS, MEGAN M (PT)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:M
Last Name:WELLS
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 W 850 S
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2197
Mailing Address - Country:US
Mailing Address - Phone:801-203-0093
Mailing Address - Fax:
Practice Address - Street 1:1952 E 7000 S STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-6878
Practice Address - Country:US
Practice Address - Phone:801-942-3311
Practice Address - Fax:801-942-5955
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6967468-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist