Provider Demographics
NPI:1053966804
Name:LONGYEAR, MEAGHAN MCGINNITY (DC)
Entity type:Individual
Prefix:DR
First Name:MEAGHAN
Middle Name:MCGINNITY
Last Name:LONGYEAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 PERIMETER PARK BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2287
Mailing Address - Country:US
Mailing Address - Phone:904-900-1477
Mailing Address - Fax:
Practice Address - Street 1:8750 PERIMETER PARK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2287
Practice Address - Country:US
Practice Address - Phone:904-900-1477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLCH12947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty