Provider Demographics
NPI:1780975284
Name:ROY, MEGAN S (OT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:S
Last Name:ROY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:S
Other - Last Name:TOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:465 AVENUE OF THE CITIES
Mailing Address - Street 2:
Mailing Address - City:EAST MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61244-4044
Mailing Address - Country:US
Mailing Address - Phone:309-779-3490
Mailing Address - Fax:309-779-5615
Practice Address - Street 1:465 AVENUE OF THE CITIES
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-4044
Practice Address - Country:US
Practice Address - Phone:309-779-3490
Practice Address - Fax:309-779-5615
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056006468225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist