Provider Demographics
NPI:1841483690
Name:MADSEN, MEGAN (DPT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:MADSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:PIETERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:16560 WEDGE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3207
Mailing Address - Country:US
Mailing Address - Phone:775-384-1400
Mailing Address - Fax:775-384-1367
Practice Address - Street 1:4773 CAUGHLIN PKWY STE 1
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-1012
Practice Address - Country:US
Practice Address - Phone:775-432-2870
Practice Address - Fax:775-432-2873
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist