Provider Demographics
NPI:1295080075
Name:PASS, MEGAN ELIZABETH RICHEY (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELIZABETH RICHEY
Last Name:PASS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:RICHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11971 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424
Mailing Address - Country:US
Mailing Address - Phone:860-898-0879
Mailing Address - Fax:844-377-2251
Practice Address - Street 1:11971 JAMES ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424
Practice Address - Country:US
Practice Address - Phone:616-345-3778
Practice Address - Fax:855-670-0383
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501301954225100000X
CT10687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist