Individual
MRS. MEGAN ROSE GASPERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
200 S. 9TH ST., DEPERE, WI 54115
(920) 338-4146
Mailing address
1450 SILVERSTONE TRAIL, APT. 9, DEPERE, WI 54115
(920) 819-1611
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1551-019
WI
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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