| NPI | 1669080552 |
|---|---|
| Former Name | MEGAN DOMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 11-06441) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO 2020038228) |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2021-11-23 |