Provider Demographics
NPI:1033542014
Name:PETTINATO, MEGAN MILLER (PT,DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MILLER
Last Name:PETTINATO
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:415 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29365-9667
Mailing Address - Country:US
Mailing Address - Phone:401-440-7045
Mailing Address - Fax:
Practice Address - Street 1:415 BUTLER RD
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:SC
Practice Address - Zip Code:29365-9667
Practice Address - Country:US
Practice Address - Phone:401-440-7045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist