Megan Ellen Antalis
Individual provider Active NPI Physical Therapy Assistant · Bloomington, IN
NPI 1740654136 · NPPES record last updated Nov 23, 2015
Key facts
- NPI
- 1740654136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 06005218A (IN)
- Practice address
- 2770 S Adams St
Bloomington, IN 47403-3242 - Phone
- (812) 323-4661
- NPI assigned
- Nov 23, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 06005218A | IN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06005218A | IN | Yes |
Addresses
Primary practice location
2770 S Adams St
Bloomington, IN 47403-3242
Mailing address
3129 S Ryan PL
Bloomington, IN 47403-4378
Phone (419) 234-7093
Other providers in Bloomington, IN
- Angela R Marshall PSYD Inc
- Angela R Marshall PSYD LLC
- Blythe Elizabeth Angle
- Daisy Day Anspach
- Emily Stenz Ansty
- Yaella Antes
- Alyssa Anthony
- Maya Antoine Abboud
- Summer Leann Appling
- Apria Healthcare LLC
All providers in Bloomington, IN · Physical Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2015. 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.