Provider Demographics
NPI:1326473703
Name:TOTORAITIS, MEGAN MARIE (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:TOTORAITIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 W INNOVATION DR STE 800
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4827
Mailing Address - Country:US
Mailing Address - Phone:414-955-1040
Mailing Address - Fax:
Practice Address - Street 1:10200 W INNOVATION DR STE 800
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4827
Practice Address - Country:US
Practice Address - Phone:414-955-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12502-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist