Individual
MEGAN TERESA GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1116 PASADERO DR, ESCONDIDO, CA 92029-3011
(210) 487-0840
Mailing address
2025 GERVAIS ST # 406C, COLUMBIA, SC 29204-1803
(210) 487-0840
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
SC519949
SC
Other
Enumeration date
05/30/2019
Last updated
07/23/2020
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