| NPI | 1013496645 |
|---|---|
| Former Name | MEGAN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 9260) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 2000022563) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2021-10-07 |