Megan Davault, PTA
Individual provider Active NPI Physical Therapy Assistant · Richland, MO
NPI 1194064998 · NPPES record last updated Feb 14, 2013
Key facts
- NPI
- 1194064998
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2012014133 (MO)
- Practice address
- 400 Tri County Lane
Richland, MO 65556-1033 - Phone
- (573) 765-3243
- NPI assigned
- Feb 14, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012014133 | MO | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Eye Care Inc | Past | Accepting new patients | |
| John Balko and Associates Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2012014133 | MO | Yes |
Addresses
Primary practice location
400 Tri County Lane
Richland, MO 65556-1033
Mailing address
22501 Highway 68
Vichy, MO 65580-8243
Phone (573) 578-7041
Other providers in Richland, MO
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- Ellen Brown
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- Earleen F Cashill
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- Elizabeth C Ewers Teel
- Rachel Fenton
- Danielle Fowers
- Robert Jaaron Fowers
- Cameron Gray
All providers in Richland, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.