Basic Information
Provider Information
NPI: 1164823258
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKEE
FirstName: MEGHAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
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Mailing Information
Address1: PO BOX 601791
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282601791
CountryCode: US
TelephoneNumber: 3367186700
FaxNumber: 3367186798
Practice Location
Address1: 11840 SOUTHMORE DR STE 100
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282774821
CountryCode: US
TelephoneNumber: 7043164441
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/09/2014
LastUpdateDate: 10/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XP14996NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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