Individual
MEGAN ROSE AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
555 E BROADWAY AVE, JACKSON, WY 83001-8640
(307) 733-3900
Mailing address
PO BOX 11801, JACKSON, WY 83002-1801
(970) 692-4136
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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