Basic Information
| Provider Information | |||||||||
| NPI: | 1700812252 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEGAN RICH PHYSICAL THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9492 DEERECO RD | ||||||||
| Address2: | |||||||||
| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210932102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103087182 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9492 DEERECO RD | ||||||||
| Address2: | |||||||||
| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210932102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103087182 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2006 | ||||||||
| LastUpdateDate: | 06/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | RICH | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | JOSEPH | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING C0-DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4103087182 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 17837 | MD | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | S285 | 01 | MD | BC/BS | OTHER | J247 | 01 | MD | BC/BS | OTHER |