Provider Demographics
NPI:1053949610
Name:BARNES, MEGAN VANDRAK (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:VANDRAK
Last Name:BARNES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29430 W WOODALL DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6906
Mailing Address - Country:US
Mailing Address - Phone:440-227-9955
Mailing Address - Fax:
Practice Address - Street 1:3275 SCIENCE PARK DR # AC-5
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7325
Practice Address - Country:US
Practice Address - Phone:216-448-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT013952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist