Provider Demographics
NPI:1861619231
Name:ELWELL, MEGAN LYNN (PT)
Entity type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:LYNN
Last Name:ELWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-1255
Mailing Address - Country:US
Mailing Address - Phone:440-258-6469
Mailing Address - Fax:
Practice Address - Street 1:5445 DETROIT RD
Practice Address - Street 2:SUITE #201
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44054-2904
Practice Address - Country:US
Practice Address - Phone:440-240-9111
Practice Address - Fax:440-934-5459
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist