Basic Information
| Provider Information | |||||||||
| NPI: | 1619908209 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STOVER | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | JONES | ||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JONES | ||||||||
| OtherFirstName: | MEGAN | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 701 SAVANNAH RD | ||||||||
| Address2: | |||||||||
| City: | LEWES | ||||||||
| State: | DE | ||||||||
| PostalCode: | 199581550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026442530 | ||||||||
| FaxNumber: | 3026442556 | ||||||||
| Practice Location | |||||||||
| Address1: | 2618 N SALISBURY BLVD STE 130 | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218012217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103247409 | ||||||||
| FaxNumber: | 4108444588 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 07/14/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | J10002095 | DE | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 29027 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.