Basic Information
| Provider Information | |||||||||
| NPI: | 1417030255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERREN | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5799 BROADMOOR STREET | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | MISSION | ||||||||
| State: | KY | ||||||||
| PostalCode: | 66202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133845600 | ||||||||
| FaxNumber: | 9133840719 | ||||||||
| Practice Location | |||||||||
| Address1: | 8516 N OAK TRFY | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641552433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164364500 | ||||||||
| FaxNumber: | 8164364510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2005012173 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.