Individual
MEGAN WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 237-9712
(701) 446-2799
Mailing address
801 17TH AVE N, FARGO, ND 58102-2226
(701) 446-2447
(701) 446-2799
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36709
ND
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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