Provider Demographics
NPI:1801164421
Name:GRAF, MEGAN ELISABETH (ATC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELISABETH
Last Name:GRAF
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 BEAGLE CLUB RD
Mailing Address - Street 2:
Mailing Address - City:UNDERWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:47177-7261
Mailing Address - Country:US
Mailing Address - Phone:502-741-5892
Mailing Address - Fax:
Practice Address - Street 1:4201 GRANT LINE RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2158
Practice Address - Country:US
Practice Address - Phone:812-941-2099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001443A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer