Individual
MEGEN Q BEJVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2500 E CAPITOL DR, APPLETON, WI 54911-8735
(920) 831-5050
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 831-5050
(920) 735-7648
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05013138A
IN
225100000X
Physical Therapist
Primary
14372
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300028434
—
IN
01
—
IN3678024
MEDICARE PTAN
IN
Enumeration date
07/18/2019
Last updated
08/02/2022
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