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Individual
MEGHAN LIVELY FASSEAS
Active
Individual
MEGHAN LIVELY FASSEAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.017272
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00776865
MEDICARE RR
IL
01
—
P00973765
MEDICARE RAILROAD
IL
Enumeration date
08/10/2009
Last updated
10/07/2014
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