Individual
MISS MEGAN PATHOOMVANH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, VATL
Contact information
Practice address
6501 CHESAPEAKE BLVD, NORFOLK, VA 23513-1974
(401) 222-9476
Mailing address
4233 LLEWELLYN AVE, APT 108, NORFOLK, VA 23504-1132
(401) 222-9476
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002178
VA
Other
Enumeration date
01/31/2015
Last updated
01/31/2015
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