Individual
MEGAN N. DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7600 SANDY ROCK PT, COLORADO SPRINGS, CO 80924-5222
(503) 744-5406
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(503) 744-5406
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTL.0013053
CO
225100000X
Physical Therapist
12142-24
WI
Other
Enumeration date
07/05/2013
Last updated
07/12/2021
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