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Individual
MEGAN FREY
Active
Individual
MEGAN FREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT-668
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000030678
NATABOC
CA
Enumeration date
08/03/2018
Last updated
08/03/2018
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