Basic Information
Provider Information
NPI: 1073897625
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRAMES
FirstName: MEGAN
MiddleName: ELISE
NamePrefix: MRS.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7300 E INDIANA ST
Address2: SUITE 102
City: EVANSVILLE
State: IN
PostalCode: 477152794
CountryCode: US
TelephoneNumber: 8124760409
FaxNumber: 8124761016
Practice Location
Address1: 7300 E INDIANA ST
Address2: SUITE 102
City: EVANSVILLE
State: IN
PostalCode: 477152794
CountryCode: US
TelephoneNumber: 8124760409
FaxNumber: 8124761016
Other Information
ProviderEnumerationDate: 09/30/2011
LastUpdateDate: 10/03/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X070.018449ILN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X05010754AINY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home