Individual
AUTUMN T MEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT
Contact information
Practice address
3044 DUE WEST ROAD, DALLAS, GA 30157-3015
(177) 044-3967
Mailing address
3044 DUE WEST RD, DALLAS, GA 30157-2125
(770) 443-9672
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007133
GA
Other
Enumeration date
09/07/2018
Last updated
07/07/2021
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