Individual
MISS MEGAN BLAIRE ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, ATC, LAT
Contact information
Practice address
4601 AMESBURY DR APT 1235, DALLAS, TX 75206-0010
(936) 554-9203
Mailing address
4601 AMESBURY DR APT 1235, DALLAS, TX 75206-0010
(936) 554-9203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5093
TX
2255A2300X
Athletic Trainer
RT005927
PA
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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