Provider Demographics
NPI:1932453420
Name:MOLWAY, MEGHAN ELIZABETH (ATC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:MOLWAY
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 1:2236 S 900 W
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46147-8901
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2236 S 900 W
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46147-8901
Practice Address - Country:US
Practice Address - Phone:317-500-1098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001756A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer