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Individual

MEGAN BROOKE FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1 COLLEGE AVE, MECHANICSBURG, PA 17055-6805
(717) 766-2511
Mailing address
1101 LINDHAM CT APT 712, MECHANICSBURG, PA 17055-8302
(719) 469-7818

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000008101
BOARD OF CERTIFICATION FOR THE ATHLETIC TRAINER
01
AT.0001028
DEPARTMENT OF REGULATORY AGENCIES
CO
01
RT005573
PENNSYLVANIA LICENSING SYSTEM
PA
Enumeration date
12/30/2018
Last updated
12/30/2018
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