| Doctor Name: | MEGAN RENEE DALE |
| NPI Number: | 1316171499 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PTA |
| License Number: | 06003545A |
| Business Practice Address: | 9909 E 100 S Greentown, IN - 469369163 |
| Business Phone Number: | 7656280605 |
| Business Fax Number: | 7656283639 |
| Mailing Address: | 42 Jacks St, GAS CITY |
| State: | IN |
| Postal Code: | 469332149 |
| Phone Number: | 7655170886 |
| Fax Number: | 7656283639 |
| NPI Enumeration Date: | 05/05/2009 |
| NPI Last Update Date: | 05/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 06003545A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |