Provider Demographics
NPI:1750984159
Name:MCKINLEY, MEGAN JEAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:JEAN
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:JEAN
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3536 MERIDIAN CROSSINGS STE 240
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-4586
Mailing Address - Country:US
Mailing Address - Phone:517-347-2495
Mailing Address - Fax:517-347-3540
Practice Address - Street 1:3536 MERIDIAN CROSSINGS STE 240
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-4586
Practice Address - Country:US
Practice Address - Phone:517-347-2495
Practice Address - Fax:517-347-3540
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019795225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist