Provider Demographics
NPI:1720450752
Name:RICHASON, MEGAN (AT)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:
Last Name:RICHASON
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 RICHLAND AVE
Mailing Address - Street 2:279
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:363 RICHLAND AVE
Practice Address - Street 2:279
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3210
Practice Address - Country:US
Practice Address - Phone:608-397-3836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0048572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer