Individual
MS. MEGHAN J TRAVERSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
687 BRANCH DR, PORT ORANGE, FL 32127-5893
(386) 682-9474
Mailing address
687 BRANCH DR, PORT ORANGE, FL 32127-5893
(386) 682-9474
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA12774
FL
Other
Enumeration date
06/01/2007
Last updated
07/08/2007
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