Individual
MEGAN WON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(417) 836-5461
Mailing address
10618 FOREST LAWN CT, SAINT LOUIS, MO 63128-1549
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2017028594
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649341272
FACILITY NPI NUMBER
MO
Enumeration date
08/09/2017
Last updated
03/17/2018
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