Provider Demographics
NPI:1770942286
Name:BLANKENSHIP, MEGHAN IRENE (DC)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:IRENE
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MEGHAN
Other - Middle Name:IRENE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:113 N BALLARD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4495
Mailing Address - Country:US
Mailing Address - Phone:972-429-1391
Mailing Address - Fax:
Practice Address - Street 1:113 N BALLARD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4495
Practice Address - Country:US
Practice Address - Phone:972-429-1391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13108111N00000X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111N00000XChiropractic ProvidersChiropractor