Individual
MEGAN LOUISE WILLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1201 SYRUP MILL RD, BLYTHEWOOD, SC 29016-8493
(616) 915-8690
Mailing address
112 SILO CT APT 235B, COLUMBIA, SC 29201-4975
(616) 915-8690
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT03076
SC
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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