Basic Information
Provider Information
NPI: 1073580692
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGARVEY
FirstName: MEGAN
MiddleName: M
NamePrefix: MRS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 E PROSPECT RD
Address2:  
City: FORT COLLINS
State: CO
PostalCode: 805259718
CountryCode: US
TelephoneNumber: 9704930112
FaxNumber: 9704930521
Practice Location
Address1: 1610 DRY CREEK DR
Address2:  
City: LONGMONT
State: CO
PostalCode: 805036405
CountryCode: US
TelephoneNumber: 7204944750
FaxNumber: 9704930521
Other Information
ProviderEnumerationDate: 03/02/2006
LastUpdateDate: 06/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPTL0015710COY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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