Individual
MEGAN LILL GRAN
Active
Individual
MEGAN LILL GRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTP-PT-TMP11073
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTP-PT-TEMP-11073
STATE PT LICENSE
MT
Enumeration date
06/16/2016
Last updated
06/16/2016
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