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Individual

MEGAN LILL GRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
103 WHITEWATER ST STE D, POLSON, MT 59860-4502
(406) 883-8101
(406) 883-8102
Mailing address
1234 WHITEFISH STAGE, KALISPELL, MT 59901-2753
(406) 756-7878
(406) 309-2579

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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