| NPI | 1942632062 |
|---|---|
| Former Name | MEAGAN ELIZABETH DICKINSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OK 780) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2020-09-04 |