Individual
MEGAN WYAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 SUMAC LN, DURHAM, NH 03824-3214
(603) 312-9112
Mailing address
20 SUMAC LN, DURHAM, NH 03824-3214
(603) 312-9112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4019
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4019
PHYSICAL THERAPY LICENSE
ID
Enumeration date
04/03/2015
Last updated
04/03/2015
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