| NPI | 1811400278 |
|---|---|
| Former Name | MEAGAN JEAN MAYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502004372) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: MI 7501000683) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2018-11-14 |